text:
The 2008 NFL draft stands out from other recent drafts. With just one projected first-round quarterback, viewed as a late first-round value and only a handful of offensive playmakers, that draft was viewed as heavy on linemen early, both offensive and defensive.
If that sounds familiar, it's because it's remarkably similar to this 2013 draft class. Luke Joeckel may be this class's Jake Long. Barkevious Mingo may be this class's Vernon Gholston. And for comparison's sake, Geno Smith hopes to be this year's Matt Ryan.
Most didn't view Matt Ryan as worthy of a top-three pick, similar to the sentiments of many about Smith. Despite the criticism, Ryan proved those evaluations wrong, nearly reaching the Super Bowl in his fifth season. Geno Smith has that same potential. But Smith, like Ryan five years ago, has a ways to go to prove those doubters wrong. He'll get a chance to improve his standing with NFL scouts, coaches and executives on Thursday at West Virginia's pro day.
After West Virginia's 5-0 start to the season—including a win at Texas—Geno Smith was poised to go from "trendy sleeper" quarterback prospect to emerging star, with NFL teams drooling at the chance to draft him. With gaudy stats, consistent ball placement, lateral mobility and great anticipation in post-snap reads, Geno Smith seized the opportunity to wow on the stat sheet and on film early in his first and only Big 12 season.
But a 35-point loss at Texas Tech followed. Then a 41-point home loss to Kansas State. Then three more defeats. Suddenly, Smith wasn't the Heisman favorite anymore and began to raise some doubts for QB-needy NFL teams. Smith finished the 2012 season admirably but lost to fellow 2013 draft prospect Ryan Nassib and Syracuse in the Pinstripe Bowl.
Based on the stat sheet and record book, Smith showed he couldn't handle pressure, that he didn't have an NFL skill set at quarterback and didn't have what it takes to be a franchise NFL quarterback.
But based on film, Smith not only remained a potential franchise quarterback but the best QB in this class.
Smith can wow with his arm and feet, but two of his best qualities have nothing to do with his arm strength or athleticism.. As I wrote in early October (http://www.optimumscouting.com/scout-s-notes/articles/scouting-notebook-the-opposite-paths-of-geno-smith-and-logan-thomas-the-next-de-freaks-and-top-10.html), his composure and confidence are what moved him up draft boards. Those characteristics not only can't be taught but are rare qualities to find in a position that demands so much from a player.
Below the neck, Smith has everything a quarterback needs. His arm strength is more than good enough, as he hit on deep throws many times in 2012 thanks to speedy Tavon Austin and Stedman Bailey at receiver. Smith's anticipation and ball placement on 15-20 yard routes is excellent, as he's one of the better passers in that area in recent drafts. His athleticism is obvious, but how he uses it is more impressive. He moves within the pocket smoothly, adjusts his body to elude pressure and works outside the pocket well. But he doesn't run unless it's completely necessary.
Making great strides from his junior to senior year, Geno Smith has become comfortable with who he is as a passer. He rarely forces passes and is developing a great understanding of touch, both vertically and the in-between levels.
Smith has a ways to go before he's an NFL elite passer. He'll need to clean up his footwork, especially in the pocket. He'll need to work on driving off his back foot on shorter routes, especially if he begins to work under center more often. And he'll need to adjust to the speed of the game, including his internal clock in the pocket and facing cornerbacks who won't allow receivers to run past them.
His QB competitors in the 2013 class don't have strong cases to overtake him. Matt Barkley of USC has concerns about his arm strength and athletic upside. Nassib doesn't have an NFL-ready deep ball and isn't consistent in his decision making. Tyler Wilson of Arkansas is a gutsy passer, but a poor 2012 season is a concern. Florida State's E.J. Manuel is fun to project in a zone read scheme, but he's far from a finished product. For most teams, Smith is the top prospect in a mediocre class.
Since 2001, a quarterback has been taken among the top four picks in every draft class. With the Jaguars, Raiders and Eagles all in need of a franchise quarterback and drafting second, third and fourth, it's hard to imagine Smith falling to No. 5 overall.
However, fans of QB-needy teams are wondering: Does the West Virginia passer have the upside of Newton, Andrew Luck or Robert Griffin?
The answer is no. Geno Smith isn't any of those guys. He's not as physical or possess as strong of an arm as Newton. He's not as savvy as Luck. He's not as fast as Griffin.
So what can we expect from Smith? Here's the best way I can put it for NFL fans who love comparisons: He's Alex Smith now and Aaron Rodgers (minus some arm strength) in the future. He can be an athletic game manager early in his career, with the upside of being a mobile, composed and productive passer in the future.
Smith may not be a flashy top-four selection and still has much to prove on his path to becoming an NFL franchise quarterback—including at his pro day Thursday. But if the Jaguars, Raiders or Eagles take a risk with Geno Smith the way Atlanta did with Ryan in 2008, they could quickly reap the rewards of going all in on Smith.


text:
When I fully entered the ranks of the food-obsessed and started reading lots of blogs I learned about roasted asparagus, grilled asparagus, and sauteed asparagus. Since then I've been on a yearly spring quest to find as many new asparagus recipes as I can.
This Roasted Asparagus with Creamy Tahini-Peanut Dipping Sauce was a fantastic success. The sauce was slightly adapted from Chicken and Quickly Roasted Asparagus with Tahini Sauce, but the added peanut butter produced a thicker sauce and I subbed agave nectar for sugar or splenda. This is a recipe I can't wait to make for guests.
Roasted Asparagus with Creamy Tahini-Peanut Dipping Sauce
(Makes 3-4 servings, although I could eat a pound of this myself. Sauce recipe adapted slightly from Chicken and Quickly Roasted Asparagus with Tahini Sauce adapted from Epicurious.com.)
1 lb. asparagus, thick spears preferred for roasting
1 T olive oil
sea salt and fresh ground black pepper to taste (I didn't use much salt)
Sauce Ingredients:
(Recipe makes enough sauce for several pounds of asparagus, but have fun thinking of other things it would taste great with.)
1/4 cup well-stirred Tahini (sesame seed paste)
1/4 cup warm water
2 T fresh squeezed lemon juice
2 tsp. agave nectar, preferably amber (can also use sugar or Splenda)
1/2 tsp. ground garlic puree from a jar (or use fresh garlic and grind in mortar and pestle)
2 tsp. soy sauce (I used Tamari)
2 T peanut butter (I use natural low-sugar peanut butter for South Beach Diet)
Put asparagus in plastic bowl and toss with olive oil, salt and pepper. Arrange in single layer on baking sheet and roast, turning once or twice, until asparagus is starting to slightly shrivel and brown and is still a little crisp in the center, about 15 minutes.
While asparagus roasts, combine tahini, warm water, lemon juice, agave nectar, garlic, soy sauce, and peanut butter in food processor, blender, or bowl attachment of an immersion blender. (If you use an immersion blender or blender, hold the lid down very tightly! I learned this the hard way.) Blend until ingredients are well combined.
Serve asparagus hot with sauce on the side for each person to dip asparagus into. Sauce can also be spooned over asparagus, but I loved dipping it, especially since this is a rich sauce.
Variations: I think this sauce would taste fantastic on roasted broccoli, cauliflower, or green beans too.
Low-Carb Diet / Low-Glycemic Diet / South Beach Diet Suggestions:
More Reasons to Love Asparagus:
Grilled Asparagus with Parmesan ~ Kalyn's Kitchen
Asparagus with Pinenuts, Lime, and Browned Butter from Nami Nami
Baked Eggs and Asparagus with Parmesan ~ Kalyn's Kitchen
Slow Butter Braised Asparagus from Steamy Kitchen

subset: commoncrawl


text:
Frequent Links
Open Access Articles- Top Results for Diabetes mellitus type 2
Journal of Gastrointestinal & Digestive SystemSix Months Results of the Duodenal-Jejunal Bypass Liner for the Treatment of Obesity and Type 2 Diabetes
Diabetes mellitus type 2
Unknown extension tag "indicator"
|Diabetes mellitus type 2
File:Blue circle for diabetes.svg
Universal blue circle symbol for diabetes[1]
|Classification and external resources
|250.00, 250.02
|Diabetes mellitus type 2
|Patient UK
|Diabetes mellitus type 2
Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterized by hyperglycemia (high blood sugar) in the context of insulin resistance and relative lack of insulin.[2] This is in contrast to diabetes mellitus type 1, in which there is an absolute lack of insulin due to breakdown of islet cells in the pancreas.[3] The classic symptoms are excess thirst, frequent urination, and constant hunger. Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes. Obesity is thought to be the primary cause of type 2 diabetes in people who are genetically predisposed to the disease (although this is not the case in people of East-Asian ancestry).
Type 2 diabetes is initially managed by increasing exercise and dietary changes. If blood sugar levels are not adequately lowered by these measures, medications such as metformin or insulin may be needed. In those on insulin, there is typically the requirement to routinely check blood sugar levels.
Rates of type 2 diabetes have increased markedly since 1960 in parallel with obesity. As of 2010 there were approximately 285 million people diagnosed with the disease compared to around 30 million in 1985.[4][5] Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy.[4] Long-term complications from high blood sugar can include heart disease, strokes, diabetic retinopathy where eyesight is affected, kidney failure which may require dialysis, and poor blood flow in the limbs leading to amputations. The acute complication of ketoacidosis, a feature of type 1 diabetes, is uncommon,[6] however hyperosmolar hyperglycemic state may occur.
Signs and symptoms
The classic symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger), and weight loss.[7] Other symptoms that are commonly present at diagnosis include a history of blurred vision, itchiness, peripheral neuropathy, recurrent vaginal infections, and fatigue.[3] Many people, however, have no symptoms during the first few years and are diagnosed on routine testing.[3] People with type 2 diabetes mellitus may rarely present with hyperosmolar hyperglycemic state (a condition of very high blood sugar associated with a decreased level of consciousness and low blood pressure).[3]
Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy.[4] This is partly due to a number of complications with which it is associated, including: two to four times the risk of cardiovascular disease, including ischemic heart disease and stroke; a 20-fold increase in lower limb amputations, and increased rates of hospitalizations.[4] In the developed world, and increasingly elsewhere, type 2 diabetes is the largest cause of nontraumatic blindness and kidney failure.[8] It has also been associated with an increased risk of cognitive dysfunction and dementia through disease processes such as Alzheimer's disease and vascular dementia.[9] Other complications include acanthosis nigricans, sexual dysfunction, and frequent infections.[7]
The development of type 2 diabetes is caused by a combination of lifestyle and genetic factors.[8][10] While some of these factors are under personal control, such as diet and obesity, other factors are not, such as increasing age, female gender, and genetics.[4] A lack of sleep has been linked to type 2 diabetes.[11] This is believed to act through its effect on metabolism.[11] The nutritional status of a mother during fetal development may also play a role, with one proposed mechanism being that of altered DNA methylation.[12]
A number of lifestyle factors are known to be important to the development of type 2 diabetes, including obesity and overweight (defined by a body mass index of greater than 25), lack of physical activity, poor diet, stress, and urbanization.[4][13] Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60-80% of cases in those of European and African descent, and 100% of cases in Pima Indians and Pacific Islanders.[3] Those who are not obese often have a high waist–hip ratio.[3]
Dietary factors also influence the risk of developing type 2 diabetes. Consumption of sugar-sweetened drinks in excess is associated with an increased risk.[14][15] The type of fats in the diet are also important, with saturated fats and trans fatty acids increasing the risk, and polyunsaturated and monounsaturated fat decreasing the risk.[10] Eating lots of white rice appears to also play a role in increasing risk.[16] A lack of exercise is believed to cause 7% of cases.[17] Persistent organic pollutants may also play a role.[18]
Most cases of diabetes involve many genes, with each being a small contributor to an increased probability of becoming a type 2 diabetic.[4] If one identical twin has diabetes, the chance of the other developing diabetes within his lifetime is greater than 90%, while the rate for nonidentical siblings is 25–50%.[3] As of 2011, more than 36 genes had been found that contribute to the risk of type 2 diabetes.[19] All of these genes together still only account for 10% of the total heritable component of the disease.[19] The TCF7L2 allele, for example, increases the risk of developing diabetes by 1.5 times and is the greatest risk of the common genetic variants.[3] Most of the genes linked to diabetes are involved in beta cell functions.[3]
There are a number of rare cases of diabetes that arise due to an abnormality in a single gene (known as monogenic forms of diabetes or "other specific types of diabetes").[3][4] These include maturity onset diabetes of the young (MODY), Donohue syndrome, and Rabson-Mendenhall syndrome, among others.[4] Maturity onset diabetes of the young constitute 1–5% of all cases of diabetes in young people.[20]
Medical conditions
There are a number of medications and other health problems that can predispose to diabetes.[21] Some of the medications include: glucocorticoids, thiazides, beta blockers, atypical antipsychotics,[22] and statins.[23] Those who have previously had gestational diabetes are at a higher risk of developing type 2 diabetes.[7] Other health problems that are associated include: acromegaly, Cushing's syndrome, hyperthyroidism, pheochromocytoma, and certain cancers such as glucagonomas.[21] Testosterone deficiency is also associated with type 2 diabetes.[24][25]
Type 2 diabetes is due to insufficient insulin production from beta cells in the setting of insulin resistance.[3] Insulin resistance, which is the inability of cells to respond adequately to normal levels of insulin, occurs primarily within the muscles, liver, and fat tissue.[26] In the liver, insulin normally suppresses glucose release. However, in the setting of insulin resistance, the liver inappropriately releases glucose into the blood.[4] The proportion of insulin resistance versus beta cell dysfunction differs among individuals, with some having primarily insulin resistance and only a minor defect in insulin secretion and others with slight insulin resistance and primarily a lack of insulin secretion.[3]
Other potentially important mechanisms associated with type 2 diabetes and insulin resistance include: increased breakdown of lipids within fat cells, resistance to and lack of incretin, high glucagon levels in the blood, increased retention of salt and water by the kidneys, and inappropriate regulation of metabolism by the central nervous system.[4] However, not all people with insulin resistance develop diabetes, since an impairment of insulin secretion by pancreatic beta cells is also required.[3]
|2 hour glucose
|Fasting glucose
|<7.8 (<140)
|<6.1 (<110)
|Impaired fasting glycaemia
|<7.8 (<140)
|≥6.1(≥110) & <7.0(<126)
|Impaired glucose tolerance
|≥7.8 (≥140)
|<7.0 (<126)
|Diabetes mellitus
|≥11.1 (≥200)
|≥7.0 (≥126)
The World Health Organization definition of diabetes (both type 1 and type 2) is for a single raised glucose reading with symptoms, otherwise raised values on two occasions, of either:[29]
- fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl)
- or
- with a glucose tolerance test, two hours after the oral dose a plasma glucose ≥ 11.1 mmol/l (200 mg/dl)
A random blood sugar of greater than 11.1 mmol/l (200 mg/dL) in association with typical symptoms[7] or a glycated hemoglobin (HbA1c) of greater than ≥ 48 mmol/mol (≥ 6.5 DCCT %) is another method of diagnosing diabetes.[4] In 2009 an International Expert Committee that included representatives of the American Diabetes Association (ADA), the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes (EASD) recommended that a threshold of ≥ 48 mmol/mol (≥ 6.5 DCCT %) should be used to diagnose diabetes.[30] This recommendation was adopted by the American Diabetes Association in 2010.[31] Positive tests should be repeated unless the person presents with typical symptoms and blood sugars >11.1 mmol/l (>200 mg/dl).[30]
Threshold for diagnosis of diabetes is based on the relationship between results of glucose tolerance tests, fasting glucose or HbA1c and complications such as retinal problems.[4] A fasting or random blood sugar is preferred over the glucose tolerance test, as they are more convenient for people.[4] HbA1c has the advantages that fasting is not required and results are more stable but has the disadvantage that the test is more costly than measurement of blood glucose.[32] It is estimated that 20% of people with diabetes in the United States do not realize that they have the disease.[4]
Diabetes mellitus type 2 is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[2] This is in contrast to diabetes mellitus type 1 in which there is an absolute insulin deficiency due to destruction of [islet cells in the pancreas and gestational diabetes mellitus that is a new onset of high blood sugars associated with pregnancy.[3] Type 1 and type 2 diabetes can typically be distinguished based on the presenting circumstances.[30] If the diagnosis is in doubt antibody testing may be useful to confirm type 1 diabetes and C-peptide levels may be useful to confirm type 2 diabetes,[33] with C-peptide levels normal or high in type 2 diabetes, but low in type 1 diabetes.[34]
No major organization recommends universal screening for diabetes as there is no evidence that such a program improve outcomes.[35][36] Screening is recommended by the United States Preventive Services Task Force (USPSTF) in adults without symptoms whose blood pressure is greater than 135/80 mmHg.[37] For those whose blood pressure is less, the evidence is insufficient to recommend for or against screening.[37]
The World Health Organization recommends testing those groups at high risk[35] and in 2014 the USPSTF is considering a similar recommendation.[38] High-risk groups in the United States include: those over 45 years old; those with a first degree relative with diabetes; some ethnic groups, including Hispanics, African-Americans, and Native-Americans; a history of gestational diabetes; polycystic ovary syndrome; excess weight; and conditions associated with metabolic syndrome.[7] The American Diabetes Association recommends screening those who have a BMI over 25 (in people of Asian descent screening is recommending for a BMI over 23.[39]
Onset of type 2 diabetes can be delayed or prevented through proper nutrition and regular exercise.[40][41] Intensive lifestyle measures may reduce the risk by over half.[8][42] The benefit of exercise occurs regardless of the person's initial weight or subsequent weight loss.[43] Evidence for the benefit of dietary changes alone, however, is limited,[44] with some evidence for a diet high in green leafy vegetables[45] and some for limiting the intake of sugary drinks.[14] In those with impaired glucose tolerance, diet and exercise either alone or in combination with metformin or acarbose may decrease the risk of developing diabetes.[8][46] Lifestyle interventions are more effective than metformin.[8] While low vitamin D levels are associated with an increased risk of diabetes, correcting the levels by supplementing vitamin D3 does not improve that risk.[47]
Management of type 2 diabetes focuses on lifestyle interventions, lowering other cardiovascular risk factors, and maintaining blood glucose levels in the normal range.[8] Self-monitoring of blood glucose for people with newly diagnosed type 2 diabetes may be used in combination with education,[48] however the benefit of self monitoring in those not using multi-dose insulin is questionable.[8][49] In those who do not want to measure blood levels, measuring urine levels may be done.[48] Managing other cardiovascular risk factors, such as hypertension, high cholesterol, and microalbuminuria, improves a person's life expectancy.[8] Decreasing the systolic blood pressure to less than 140 mmHg is associated with a lower risk of death and better outcomes.[50] Intensive blood pressure management (less than 130/80 mmHg) as opposed to standard blood pressure management (less than 140/85–100 mmHg) results in a slight decrease in stroke risk but no effect on overall risk of death.[51]
Intensive blood sugar lowering (HbA1c<6%) as opposed to standard blood sugar lowering (HbA1c of 7–7.9%) does not appear to change mortality.[52][53] The goal of treatment is typically an HbA1c of around 7% or a fasting glucose of less than 7.2 mmol/L (130 mg/dL); however these goals may be changed after professional clinical consultation, taking into account particular risks of hypoglycemia and life expectancy.[54][55] It is recommended that all people with type 2 diabetes get regular ophthalmology examination.[3] Treating gum disease in those with diabetes may result in a small improvement in blood sugar levels.[56]
A proper diet and exercise are the foundations of diabetic care,[7] with a greater amount of exercise yielding better results.[57] Aerobic exercise leads to a decrease in HbA1c and improved insulin sensitivity.[57] Resistance training is also useful and the combination of both types of exercise may be most effective.[57] A diabetic diet that promotes weight loss is important.[58] While the best diet type to achieve this is controversial,[58] a low glycemic index diet has been found to improve blood sugar control.[59] Culturally appropriate education may help people with type 2 diabetes control their blood sugar levels, for up to six months at least.[60] If changes in lifestyle in those with mild diabetes has not resulted in improved blood sugars within six weeks, medications should then be considered.[7] There is not enough evidence to determine if lifestyle interventions affect mortality in those who already have DM2.[42]
There are several classes of anti-diabetic medications available. Metformin is generally recommended as a first line treatment as there is some evidence that it decreases mortality;[8] however, this conclusion is questioned.[61] Metformin should not be used in those with severe kidney or liver problems.[7]
A second oral agent of another class or insulin may be added if metformin is not sufficient after three months.[54] Other classes of medications include: sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, SGLT2 inhibitors, and glucagon-like peptide-1 analog.[54] There is no significant difference between these agents.[54] Rosiglitazone, a thiazolidinedione, has not been found to improve long-term outcomes even though it improves blood sugar levels.[62] Additionally it is associated with increased rates of heart disease and death.[63] Angiotensin-converting enzyme inhibitors (ACEIs) prevent kidney disease and improve outcomes in those with diabetes.[64][65] The similar medications angiotensin receptor blockers (ARBs) do not.[65]
Injections of insulin may either be added to oral medication or used alone.[8] Most people do not initially need insulin.[3] When it is used, a long-acting formulation is typically added at night, with oral medications being continued.[7][8] Doses are then increased to effect (blood sugar levels being well controlled).[8] When nightly insulin is insufficient, twice daily insulin may achieve better control.[7] The long acting insulins glargine and detemir are equally safe and effective,[66] and do not appear much better than neutral protamine Hagedorn (NPH) insulin, but as they are significantly more expensive, they are not cost effective as of 2010.[67] In those who are pregnant insulin is generally the treatment of choice.[7]
Weight loss surgery in those who are obese is an effective measure to treat diabetes.[68] Many are able to maintain normal blood sugar levels with little or no medications following surgery[69] and long-term mortality is decreased.[70] There however is some short-term mortality risk of less than 1% from the surgery.[71] The body mass index cutoffs for when surgery is appropriate are not yet clear.[70] It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.[72]
Globally as of 2010 it was estimated that there were 285 million people with type 2 diabetes making up about 90% of diabetes cases.[4] This is equivalent to about 6% of the world's adult population.[73] Diabetes is common both in the developed and the developing world.[4] It remains uncommon, however, in the underdeveloped world.[3]
Women seem to be at a greater risk as do certain ethnic groups,[4][74] such as South Asians, Pacific Islanders, Latinos, and Native Americans.[7] This may be due to enhanced sensitivity to a Western lifestyle in certain ethnic groups.[75] Traditionally considered a disease of adults, type 2 diabetes is increasingly diagnosed in children in parallel with rising obesity rates.[4] Type 2 diabetes is now diagnosed as frequently as type 1 diabetes in teenagers in the United States.[3]
Rates of diabetes in 1985 were estimated at 30 million, increasing to 135 million in 1995 and 217 million in 2005.[5] This increase is believed to be primarily due to the global population aging, a decrease in exercise, and increasing rates of obesity.[5] The five countries with the greatest number of people with diabetes as of 2000 are India having 31.7 million, China 20.8 million, the United States 17.7 million, Indonesia 8.4 million, and Japan 6.8 million.[76] It is recognized as a global epidemic by the World Health Organization.[77]
Diabetes is one of the first diseases described[78] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[79] The first described cases are believed to be of type 1 diabetes.[79] Indian physicians around the same time identified the disease and classified it as madhumeha or honey urine noting that the urine would attract ants.[79] The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Appollonius Of Memphis.[79] The disease was rare during the time of the Roman empire with Galen commenting that he had only seen two cases during his career.[79]
Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400-500 AD with type 1 associated with youth and type 2 with being overweight.[79] The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus which is also associated with frequent urination.[79] Effective treatment was not developed until the early part of the 20th century when the Canadians Frederick Banting and Charles Best discovered insulin in 1921 and 1922.[79] This was followed by the development of the long acting NPH insulin in the 1940s.[79]
- ↑ "Diabetes Blue Circle Symbol". International Diabetes Federation. 17 March 2006.
- ↑ 2.0 2.1 Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Cotran, Ramzi S. ; Robbins, Stanley L. (2005). Robbins and Cotran Pathologic Basis of Disease (7th ed.). Philadelphia, Pa.: Saunders. pp. 1194–1195. ISBN 0-7216-0187-1.
- ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 Shoback, edited by David G. Gardner, Dolores (2011). Greenspan's basic & clinical endocrinology (9th ed.). New York: McGraw-Hill Medical. pp. Chapter 17. ISBN 0-07-162243-8.
- ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 Williams textbook of endocrinology. (12th ed.). Philadelphia: Elsevier/Saunders. pp. 1371–1435. ISBN 978-1-4377-0324-5.
- ↑ 5.0 5.1 5.2 Smyth, S; Heron, A (January 2006). "Diabetes and obesity: the twin epidemics". Nature Medicine 12 (1): 75–80. PMID 16397575. doi:10.1038/nm0106-75.
- ↑ Fasanmade, OA; Odeniyi, IA; Ogbera, AO (June 2008). "Diabetic ketoacidosis: diagnosis and management". African journal of medicine and medical sciences 37 (2): 99–105. PMID 18939392.
- ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 Vijan, S (2010-03-02). "Type 2 diabetes". Annals of internal medicine 152 (5): ITC31–15; quiz ITC316. PMID 20194231. doi:10.7326/0003-4819-152-5-201003020-01003.
- ↑ 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 Ripsin CM, Kang H, Urban RJ (January 2009). "Management of blood glucose in type 2 diabetes mellitus". Am Fam Physician 79 (1): 29–36. PMID 19145963.
- ↑ Pasquier, F (October 2010). "Diabetes and cognitive impairment: how to evaluate the cognitive status?". Diabetes & metabolism. 36 Suppl 3: S100–5. PMID 21211730. doi:10.1016/S1262-3636(10)70475-4.
- ↑ 10.0 10.1 Risérus U, Willett WC, Hu FB (January 2009). "Dietary fats and prevention of type 2 diabetes". Progress in Lipid Research 48 (1): 44–51. PMC 2654180. PMID 19032965. doi:10.1016/j.plipres.2008.10.002.
- ↑ 11.0 11.1 Touma, C; Pannain, S (August 2011). "Does lack of sleep cause diabetes?". Cleveland Clinic journal of medicine 78 (8): 549–58. PMID 21807927. doi:10.3949/ccjm.78a.10165.
- ↑ Christian, P; Stewart, CP (March 2010). "Maternal micronutrient deficiency, fetal development, and the risk of chronic disease". The Journal of nutrition 140 (3): 437–45. PMID 20071652. doi:10.3945/jn.109.116327.
- ↑ Abdullah, A; Peeters, A; de Courten, M; Stoelwinder, J (September 2010). "The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies.". Diabetes research and clinical practice 89 (3): 309–19. PMID 20493574. doi:10.1016/j.diabres.2010.04.012.
- ↑ 14.0 14.1 Malik, VS; Popkin, BM; Bray, GA; Després, JP; Hu, FB (2010-03-23). "Sugar Sweetened Beverages, Obesity, Type 2 Diabetes and Cardiovascular Disease risk". Circulation 121 (11): 1356–64. PMC 2862465. PMID 20308626. doi:10.1161/CIRCULATIONAHA.109.876185.
- ↑ Malik, VS; Popkin, BM; Bray, GA; Després, JP; Willett, WC; Hu, FB (November 2010). "Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A meta-analysis". Diabetes Care 33 (11): 2477–83. PMC 2963518. PMID 20693348. doi:10.2337/dc10-1079.
- ↑ Hu, EA; Pan, A; Malik, V; Sun, Q (2012-03-15). "White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review". BMJ (Clinical research ed.) 344: e1454. PMC 3307808. PMID 22422870. doi:10.1136/bmj.e1454.
- ↑ Lee, I-Min; Shiroma, Eric J; Lobelo, Felipe; Puska, Pekka; Blair, Steven N; Katzmarzyk, Peter T (1 July 2012). "Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy". The Lancet 380 (9838): 219–29. PMC 3645500. PMID 22818936. doi:10.1016/S0140-6736(12)61031-9.
- ↑ Lind, L; Lind, PM (Jun 2012). "Can persistent organic pollutants and plastic-associated chemicals cause cardiovascular disease?". Journal of internal medicine 271 (6): 537–53. PMID 22372998. doi:10.1111/j.1365-2796.2012.02536.x.
- ↑ 19.0 19.1 Herder, C; Roden, M (June 2011). "Genetics of type 2 diabetes: pathophysiologic and clinical relevance". European journal of clinical investigation 41 (6): 679–92. PMID 21198561. doi:10.1111/j.1365-2362.2010.02454.x.
- ↑ "Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-onset Diabetes of the Young". National Diabetes Information Clearinghouse (NDIC) (National Institute of Diabetes and Digestive and Kidney Diseases, NIH). March 2007. Retrieved 2008-08-04.
- ↑ 21.0 21.1 Bethel, edited by Mark N. Feinglos, M. Angelyn (2008). Type 2 diabetes mellitus: an evidence-based approach to practical management. Totowa, NJ: Humana Press. p. 462. ISBN 978-1-58829-794-5.
- ↑ Izzedine, H; Launay-Vacher, V; Deybach, C; Bourry, E; Barrou, B; Deray, G (November 2005). "Drug-induced diabetes mellitus". Expert opinion on drug safety 4 (6): 1097–109. PMID 16255667. doi:10.1517/147403184.108.40.2067.
- ↑ Sampson, UK; Linton, MF; Fazio, S (July 2011). "Are statins diabetogenic?". Current Opinion in Cardiology 26 (4): 342–7. PMC 3341610. PMID 21499090. doi:10.1097/HCO.0b013e3283470359.
- ↑ Saad F, Gooren L (March 2009). "The role of testosterone in the metabolic syndrome: a review". The Journal of Steroid Biochemistry and Molecular Biology 114 (1–2): 40–3. PMID 19444934. doi:10.1016/j.jsbmb.2008.12.022.
- ↑ Farrell JB, Deshmukh A, Baghaie AA (2008). "Low testosterone and the association with type 2 diabetes". The Diabetes Educator 34 (5): 799–806. PMID 18832284. doi:10.1177/0145721708323100.
- ↑ Diabetes mellitus a guide to patient care. Philadelphia: Lippincott Williams & Wilkins. 2007. p. 15. ISBN 978-1-58255-732-8.
- ↑ Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation (PDF). Geneva: World Health Organization. 2006. p. 21. ISBN 978-92-4-159493-6.
- ↑ Vijan, S (March 2010). "Type 2 diabetes". Annals of Internal Medicine 152 (5): ITC31-15. PMID 20194231. doi:10.1059/0003-4819-152-5-201003020-01003.
- ↑ World Health Organization. "Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO Consultation. Part 1. Diagnosis and classification of diabetes mellitus". Retrieved 2007-05-29.
- ↑ 30.0 30.1 30.2 International Expert, Committee (July 2009). "International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes". Diabetes Care 32 (7): 1327–34. PMC 2699715. PMID 19502545. doi:10.2337/dc09-9033.
- ↑ "Diagnosis and classification of diabetes mellitus". Diabetes Care (American Diabetes Association). 33 Suppl 1 (Supplement_1): S62–9. January 2010. PMC 2797383. PMID 20042775. doi:10.2337/dc10-S062.
- ↑ "Diagnosis and classification of diabetes mellitus". Diabetes Care (American Diabetes Association). 35 Suppl 1 (Suppl 1): S64–71. January 2012. PMC 3632174. PMID 22187472. doi:10.2337/dc12-s064.
- ↑ Diabetes mellitus a guide to patient care. Philadelphia: Lippincott Williams & Wilkins. 2007. p. 201. ISBN 978-1-58255-732-8.
- ↑ Mary Lee (2013). Basic Skills in Interpreting Laboratory Data. ASHP. pp. Chapter 13. ISBN 9781585283453.
- ↑ 35.0 35.1 Valdez R (2009). "Detecting Undiagnosed Type 2 Diabetes: Family History as a Risk Factor and Screening Tool". J Diabetes Sci Technol 3 (4): 722–6. PMC 2769984. PMID 20144319. doi:10.1177/193229680900300417.
- ↑ Selph, S; Dana, T; Blazina, I; Bougatsos, C; Patel, H; Chou, R (14 April 2015). "Screening for Type 2 Diabetes Mellitus: A Systematic Review for the U.S. Preventive Services Task Force.". Annals of internal medicine. PMID 25867111.
- ↑ 37.0 37.1 "Screening: Type 2 Diabetes Mellitus in Adults". U.S. Preventive Services Task Force. 2008. Retrieved 2014-03-16.
- ↑ "Draft Recommendation Statement Screening for Abnormal Glucose and Type 2 Diabetes Mellitus". http://www.uspreventiveservicestaskforce.org/. Retrieved 7 October 2014.
- ↑ "Standards of Medical Care in Diabetes--2015: Summary of Revisions". Diabetes Care 54 (38): S4. 2015. PMID 25537706. doi:10.2337/dc15-S003.
- ↑ Raina Elley C, Kenealy T (December 2008). "Lifestyle interventions reduced the long-term risk of diabetes in adults with impaired glucose tolerance". Evid Based Med 13 (6): 173. PMID 19043031. doi:10.1136/ebm.13.6.173.
- ↑ Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roqué I Figuls M, Richter B, Mauricio D (2008). Mauricio, Didac, ed. "Exercise or exercise and diet for preventing type 2 diabetes mellitus". Cochrane Database Syst Rev (3): CD003054. PMID 18646086. doi:10.1002/14651858.CD003054.pub3.
- ↑ 42.0 42.1 Schellenberg, ES.; Dryden, DM.; Vandermeer, B.; Ha, C.; Korownyk, C. (October 2013). "Lifestyle Interventions for Patients With and at Risk for Type 2 Diabetes: A Systematic Review and Meta-analysis". Ann Intern Med 159 (8): 543–51. PMID 24126648. doi:10.7326/0003-4819-159-8-201310150-00007.
- ↑ O'Gorman, DJ; Krook, A (September 2011). "Exercise and the treatment of diabetes and obesity". The Medical clinics of North America 95 (5): 953–69. PMID 21855702. doi:10.1016/j.mcna.2011.06.007.
- ↑ Nield L, Summerbell CD, Hooper L, Whittaker V, Moore H (2008). Nield, Lucie, ed. "Dietary advice for the prevention of type 2 diabetes mellitus in adults". Cochrane Database Syst Rev (3): CD005102. PMID 18646120. doi:10.1002/14651858.CD005102.pub2.
- ↑ Carter, P; Gray, LJ; Troughton, J; Khunti, K; Davies, MJ (2010-08-18). "Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis". BMJ (Clinical research ed.) 341: c4229. PMC 2924474. PMID 20724400. doi:10.1136/bmj.c4229.
- ↑ Santaguida PL, Balion C, Hunt D et al. (August 2005). "Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose" (PDF). Evid Rep Technol Assess (Summ) (128): 1–11. PMID 16194123.
- ↑ Seida, Jennifer C.; Mitri, Joanna; Colmers, Isabelle N.; Majumdar, Sumit R.; Davidson, Mayer B.; Edwards, Alun L.; Hanley, David A.; Pittas, Anastassios G.; Tjosvold, Lisa; Johnson, Jeffrey A. (Oct 2014). "Effect of Vitamin D3 Supplementation on Improving Glucose Homeostasis and Preventing Diabetes: A Systematic Review and Meta-Analysis". The Journal of Clinical Endocrinology & Metabolism 99 (10): 3551–3560. PMID 25062463. doi:10.1210/jc.2014-2136.
- ↑ 48.0 48.1 "Type 2 diabetes: The management of type 2 diabetes". May 2009.
- ↑ Farmer, AJ; Perera, R; Ward, A; Heneghan, C; Oke, J; Barnett, AH; Davidson, MB; Guerci, B; Coates, V; Schwedes, U; O'Malley, S (27 February 2012). "Meta-analysis of individual patient data in randomised trials of self monitoring of blood glucose in people with non-insulin treated type 2 diabetes". BMJ (Clinical research ed.) 344: e486. PMID 22371867. doi:10.1136/bmj.e486.
- ↑ Emdin, CA; Rahimi, K; Neal, B; Callender, T; Perkovic, V; Patel, A (10 February 2015). "Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis.". JAMA 313 (6): 603–15. PMID 25668264. doi:10.1001/jama.2014.18574.
- ↑ McBrien, K; Rabi, DM; Campbell, N; Barnieh, L; Clement, F; Hemmelgarn, BR; Tonelli, M; Leiter, LA; Klarenbach, SW; Manns, BJ (6 August 2012). "Intensive and Standard Blood Pressure Targets in Patients With Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis". Archives of Internal Medicine 172 (17): 1–8. PMID 22868819. doi:10.1001/archinternmed.2012.3147.
- ↑ Boussageon, R; Bejan-Angoulvant, T; Saadatian-Elahi, M; Lafont, S; Bergeonneau, C; Kassaï, B; Erpeldinger, S; Wright, JM; Gueyffier, F; Cornu, C (2011-07-26). "Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials". BMJ (Clinical research ed.) 343: d4169. PMC 3144314. PMID 21791495. doi:10.1136/bmj.d4169.
- ↑ Webster, MW (July 2011). "Clinical practice and implications of recent diabetes trials". Current Opinion in Cardiology 26 (4): 288–93. PMID 21577100. doi:10.1097/HCO.0b013e328347b139.
- ↑ 54.0 54.1 54.2 54.3 Inzucchi, SE; Bergenstal, RM; Buse, JB; Diamant, M; Ferrannini, E; Nauck, M; Peters, AL; Tsapas, A; Wender, R; Matthews, DR (March 2015). "Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes.". Diabetologia 58 (3): 429–42. PMID 25583541. doi:10.1007/s00125-014-3460-0.
- ↑ "Standards of medical care in diabetes--2015: summary of revisions.". Diabetes Care 38: S4. Jan 2015. PMID 25537706. doi:10.2337/dc15-S003.
- ↑ Simpson, TC.; Needleman, I.; Wild, SH.; Moles, DR.; Mills, EJ. (2010). Simpson, Terry C, ed. "Treatment of periodontal disease for glycaemic control in people with diabetes". Cochrane Database Syst Rev (5): CD004714. PMID 20464734. doi:10.1002/14651858.CD004714.pub2.
- ↑ 57.0 57.1 57.2 Zanuso S, Jimenez A, Pugliese G, Corigliano G, Balducci S (March 2010). "Exercise for the management of type 2 diabetes: a review of the evidence". Acta Diabetol 47 (1): 15–22. PMID 19495557. doi:10.1007/s00592-009-0126-3.
- ↑ 58.0 58.1 Davis N, Forbes B, Wylie-Rosett J (June 2009). "Nutritional strategies in type 2 diabetes mellitus". Mt. Sinai J. Med. 76 (3): 257–68. PMID 19421969. doi:10.1002/msj.20118.
- ↑ Thomas D, Elliott EJ (2009). Thomas, Diana, ed. "Low glycaemic index, or low glycaemic load, diets for diabetes mellitus". Cochrane Database Syst Rev (1): CD006296. PMID 19160276. doi:10.1002/14651858.CD006296.pub2.
- ↑ Hawthorne, K.; Robles, Y.; Cannings-John, R.; Edwards, A. G. K.; Robles, Yolanda (2008). Robles, Yolanda, ed. "Culturally appropriate health education for Type 2 diabetes mellitus in ethnic minority groups". Cochrane Database Syst Rev (3): CD006424. PMID 18646153. doi:10.1002/14651858.CD006424.pub2. CD006424.
- ↑ Boussageon, R; Supper, I; Bejan-Angoulvant, T; Kellou, N; Cucherat, M; Boissel, JP; Kassai, B; Moreau, A; Gueyffier, F; Cornu, C (2012). Groop, Leif, ed. "Reappraisal of metformin efficacy in the treatment of type 2 diabetes: a meta-analysis of randomised controlled trials". PLoS medicine 9 (4): e1001204. PMC 3323508. PMID 22509138. doi:10.1371/journal.pmed.1001204.
- ↑ Richter, B; Bandeira-Echtler, E; Bergerhoff, K; Clar, C; Ebrahim, SH (18 July 2007). Richter, Bernd, ed. "Rosiglitazone for type 2 diabetes mellitus". The Cochrane database of systematic reviews (3): CD006063. PMID 17636824. doi:10.1002/14651858.CD006063.pub2.
- ↑ Chen, X; Yang, L; Zhai, SD (December 2012). "Risk of cardiovascular disease and all-cause mortality among diabetic patients prescribed rosiglitazone or pioglitazone: a meta-analysis of retrospective cohort studies". Chinese medical journal 125 (23): 4301–6. PMID 23217404.
- ↑ Lv, J; Perkovic, V; Foote, CV; Craig, ME; Craig, JC; Strippoli, GF (12 December 2012). Strippoli, Giovanni FM, ed. "Antihypertensive agents for preventing diabetic kidney disease". The Cochrane database of systematic reviews 12: CD004136. PMID 23235603. doi:10.1002/14651858.CD004136.pub3.
- ↑ 65.0 65.1 Cheng, J; Zhang, W; Zhang, X; Han, F; Li, X; He, X; Li, Q; Chen, J (May 2014). "Effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on all-cause mortality, cardiovascular deaths, and cardiovascular events in patients with diabetes mellitus: a meta-analysis.". JAMA internal medicine 174 (5): 773–85. PMID 24687000. doi:10.1001/jamainternmed.2014.348.
- ↑ Swinnen, SG.; Simon, AC.; Holleman, F.; Hoekstra, JB.; Devries, JH. (2011). Simon, Airin CR, ed. "Insulin detemir versus insulin glargine for type 2 diabetes mellitus". Cochrane Database Syst Rev (7): CD006383. PMID 21735405. doi:10.1002/14651858.CD006383.pub2.
- ↑ Waugh, N; Cummins, E; Royle, P; Clar, C; Marien, M; Richter, B; Philip, S (July 2010). "Newer agents for blood glucose control in type 2 diabetes: systematic review and economic evaluation". Health technology assessment (Winchester, England) 14 (36): 1–248. PMID 20646668. doi:10.3310/hta14360.
- ↑ Picot, J; Jones, J; Colquitt, JL; Gospodarevskaya, E; Loveman, E; Baxter, L; Clegg, AJ (September 2009). "The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation". Health technology assessment (Winchester, England) 13 (41): 1–190, 215–357, iii–iv. PMID 19726018. doi:10.3310/hta13410.
- ↑ Frachetti, KJ; Goldfine, AB (April 2009). "Bariatric surgery for diabetes management". Current Opinion in Endocrinology, Diabetes and Obesity 16 (2): 119–24. PMID 19276974. doi:10.1097/MED.0b013e32832912e7.
- ↑ 70.0 70.1 Schulman, AP; del Genio, F, Sinha, N, Rubino, F (September–October 2009). ""Metabolic" surgery for treatment of type 2 diabetes mellitus". Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 15 (6): 624–31. PMID 19625245. doi:10.4158/EP09170.RAR.
- ↑ Colucci, RA (January 2011). "Bariatric surgery in patients with type 2 diabetes: a viable option". Postgraduate Medicine 123 (1): 24–33. PMID 21293081. doi:10.3810/pgm.2011.01.2242.
- ↑ Dixon, JB; le Roux, CW; Rubino, F; Zimmet, P (16 June 2012). "Bariatric surgery for type 2 diabetes". Lancet 379 (9833): 2300–11. PMID 22683132. doi:10.1016/S0140-6736(12)60401-2.
- ↑ Meetoo, D; =McGovern, P; Safadi, R (13–27 September 2007). "An epidemiological overview of diabetes across the world". British journal of nursing (Mark Allen Publishing) 16 (16): 1002–7. PMID 18026039.
- ↑ Abate N, Chandalia M (2001). "Ethnicity and type 2 diabetes: focus on Asian Indians". J. Diabetes Complicat. 15 (6): 320–7. PMID 11711326. doi:10.1016/S1056-8727(01)00161-1.
- ↑ Carulli, L; Rondinella, S; Lombardini, S; Canedi, I; Loria, P; Carulli, N (November 2005). "Review article: diabetes, genetics and ethnicity". Alimentary pharmacology & therapeutics. 22 Suppl 2: 16–9. PMID 16225465. doi:10.1111/j.1365-2036.2005.02588.x.
- ↑ Wild S, Roglic G, Green A, Sicree R, King H (May 2004). "Global prevalence of diabetes: estimates for the year 2000 and projections for 2030". Diabetes Care 27 (5): 1047–53. PMID 15111519. doi:10.2337/diacare.27.5.1047.
- ↑ "Diabetes Fact sheet N°312". World Health Organization. August 2011. Retrieved 2012-01-09.
- ↑ Ripoll, Brian C. Leutholtz, Ignacio (2011-04-25). Exercise and disease management (2nd ed.). Boca Raton: CRC Press. p. 25. ISBN 978-1-4398-2759-8.
- ↑ 79.0 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 editor, Leonid Poretsky, (2009). Principles of diabetes mellitus (2nd ed.). New York: Springer. p. 3. ISBN 978-0-387-09840-1.
External links
- Diabetes mellitus type 2 at DMOZ
- National Diabetes Information Clearinghouse
- Centers for Disease Control (Endocrine pathology)


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Prize Recipient
Cesar Caro
I've lived in Delaware all my life and have been a member of my local community for nearly as long. I suppose my interest in physics stems from my father, who came to this country to study that very subject. As a result, I have wanted to be a physicist ever since I can remember, although now that I am more mature I have developed a more philosophic standing to support my goal of studying Unified Field Theory and space-time topology. In addition to physical contemplation, I enjoy running, classical music, artistic photography, playing the trombone, and writing poetry and music. I will be attending Princeton University starting this Fall, 2004.


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Quick Facts
- 610-954-4838
- 801 Ostrum St, Bethlehem, PA
- 3 specialties
- 5 affiliated hospitals
- 2 insurance providers
- 1 school
- English
- 2 are board certified
- 2 are male
- 3 specialties
- 2 health insurance companies
Accepted Insurance
- Highmark BCBS
- BCBS Blue Card
Doctors in Radiology Physicians of Muhlenberg Group
- Dr. Edgar Cheng MD Diagnostic Radiology, Radiology, Nuclear Medicine Bethlehem, PA
- Dr. Eli Jacobs DO Radiology, Nuclear Medicine, Diagnostic Radiology Doylestown, PA
3 specialties
A radiologist is a physician who specializes in the use of medical imaging to diagnose and treat illnesses or injuries in patients.
The different types of medical imaging are X-ray, computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasound, and nuclear medicine.
Radiologists are experts in these different types of tests and can advise a primary care doctor on which test is most appropriate in a specific case. These doctors also assist primary care doctors in analyzing the images produced by these tests in order to determine next steps necessary for treatment.
Diagnostic Radiology
Radiologists help doctors get a closer look at what's happening inside your body. If your primary care doctor wants to investigate your symptoms further, they may refer you to a radiologist to get an ultrasound or x-ray. Some radiologists specialize in mammography and breast imaging, which is who you see when you need a mammogram. A Radiologist can also determine if bones are broken or fractured after any kind of accident.
Radiologists are trained to perform MRIs and CT scans, both of which are used to determine the presence of diseases or disorders and help your doctor properly diagnose you. They can detect anything from tumors, bleeding and infections to bone and muscle disorders.
Nuclear Medicine
Nuclear medicine specialists are doctors who have extensive training in the use of nuclear substances, like radiation, to diagnose and treat certain illnesses.
These specialists perform diagnostic tests in which a small amount of a radioactive substance is injected into a vein, inhaled or taken orally by the patient. The radioactive substance then enables the nuclear medicine specialist to use a scanner to detect the radiation level in the part of the body being examined in order to create an image of it with a computer. The images tell the physician whether there are abnormal changes in metabolism which indicate whether a disease or injury is present. These tests are often used to detect cancer.
In addition to detecting cancer, substances like radioactive iodine can be either injected into the blood stream or taken orally to fight cancer and other diseases. After being ingested, the substance is absorbed by the thyroid gland and abnormal thyroid tissues are destroyed.
Hospital Affiliations
Radiology Physicians of Muhlenberg Group is affiliated with the following hospitals
- St Luke's Hospital - Allentown Campus Allentown, PA 18104
- St. Luke's Hospital - Quakertown Campus Quakertown, PA 18951
- St. Luke's Hospital - Miners Campus Coaldale, PA 18218
- St Luke's Anderson Hospital Easton, PA 18045
- St Luke's University Hospital - Bethlehem Campus Bethlehem, PA 18015
Affiliated doctors have gone to the following school
- State University Of New York Upstate Medical University
Nearby Group Practices
Radiology Physicians of Muhlenberg Group is similar to the following 3 Group Pracices near Bethlehem, PA.
Orthopedic Surgical Group Priscilla Paye Hurd Pavillion
Group Practice
Bethlehem, PA
St Lukes Physician Group Dba St Lukes Trauma Associates
Group Practice
Bethlehem, PA
Anesthesia Specialists of Bethlehem Center For Specialisted
Group Practice
Bethlehem, PA
Information About Group Practices
What is a Group Practice?
According to The Medical Group Management Association, a group practice is any relationship between three or more physicians who share facilities, expenses, profits and other resources like support staff and equipment. Group practices tend to fall into two categories: those that organize around a particular medical specialty and those that encompass several specialties like East Boston Neighborhood Health that specializes in internal medicine
Why Group Practice?
As medicine became more complex in the twentieth century, the need for group practices made more sense. Physicians found it impossible to know everything about the emerging drugs and technologies on the medical landscape. In addition, the cost of providing a full range of diagnostic services, such as tests and X-rays, in one location became prohibitive to the individual practitioner. Hence, doctors from various disciplines began to team together in order to provide more comprehensive care to their community of patients.
Benefits of Group Practice
As medicine became more complex in the twentieth century, the need for group practices made more sense. Physicians found it impossible to know everything about the emerging drugs and technologies on the medical landscape. In addition, the cost of providing a full range of diagnostic services, such as tests and X-rays, in one location became prohibitive to the individual practitioner. Hence, doctors from various disciplines began to team together in order to provide more comprehensive care to their community of patients.


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Investigations are ongoing in the Jan. 31 string of traffic crashes along I-75 that killed three and injured at least 20, according to a release from Michigan State Police.
An adult driver and a 10-year-old child coming from Canada in a Mazda were released from Detroit Receiving and Children's Hospital, respectively, today.
The woman passenger in the Mazda has been upgraded to serious condition, as well, say authorities. She remains at Detroit Receiving Hospital.
A total of 43 vehicles -- in 12 accidents along the highway from Springwells to Dearborn Avenue -- were involved in the pileup, say police.
State troopers are still investigating the two fatal crashes, as they wait on toxicology results and vehicle inspections by reconstruction crews.
Check back later for more on this story.


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PLANS to develop a new Winchester skate park have been given the go ahead despite proposals that could see it torn down in just a few years.
In October, the Veolia Environmental Trust gave the city council a £100,000 grant through the Landfill Communities Fund for a new skate park by the River Park Leisure Centre.
It's intended to replace the existing park which officers say is worn out.
Civic chiefs agreed to fund the shortfall of £25,000 from the sport pot of the Winchester Town Open Space Fund at last Wednesday's town forum (January 22).
The new park will include equipment for BMXs, skateboards, rollerblades and scooters and is part of a wider plan to overhaul the leisure facilities at North Walls Recreation Ground.
Ongoing discussions about the proposed River Park Leisure Centre rebuild could see the new skate park torn down in as little as three years if councillors decide to go ahead with the controversial build.
However councillors voted unanimously for the project to go ahead.
Cllr James Maynard said: "In terms of spending money I can't think of anything better to spend our Open Space funds on."
Cllr Robert Sanders said: "This council has been unanimously behind this project. There would be a huge number of teenagers who would be disappointed if we didn't go through with this."


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Andover, KS, U.S.A.
Kristian A. Strom has been a bookseller for over 10 years. I am a member of the IOBA (Independent Online Booksellers Association), and adhere to a strict code of ethics and the most professional standards of bookselling. I have taken every measure to maintain a near perfect feedback rating on Amazon(5.0 out of 5.0) and Ebay (100% positive with over 4300 ratings). I enjoy helping customers, individuals, libraries, professors, and book lovers of all varieties locate rare and out-of-print books.
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Emilion Collection by ELK Lighting
These gorgeous burnt bronze finished chandeliers are the perfect accessory for an elegant, formal dining room. With your choice of candelabra or medium bulbs, you'll light your next dinner party to perfection. Choose from hanging chandeliers, ceiling sconces, or wall sconces to blend with your style. The frosted glass shades add the perfect finish.


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Hellickson's up-and-down outing can't match Sale
Right-hander fans eight, walks four over six innings; Lobaton homers
CHICAGO -- For much of his time on the mound Thursday night, Jeremy Hellickson was virtually untouchable. But a shaky beginning and a staggering finish was enough to do him in and end the Rays' streak of impressive starts in a 5-2 loss to the White Sox at U.S. Cellular Field.
Hellickson (1-2) allowed five runs (all earned) on five hits in six innings. He allowed three runs in the first inning and then was touched up for a two-run home run in the sixth. In between, he allowed just one hit while registering seven of his eight strikeouts.
Before Thursday, Rays starters had gone at least eight innings in the previous three games. Over the previous five games, the starters had held opponents to a .137 batting average (21-for-153). But it was apparent early on Thursday that both streaks would be in jeopardy.
"The first inning he was not sharp," Rays manager Joe Maddon said of Hellickson. "Everything was up and they took advantage. They got their three runs and they did a nice job of situational hitting in the first. Then he was really good. Fastball was down, changeup was down and the curveball was really good."
Hellickson has allowed 15 runs this season, with eight of them coming in the first inning.
"I couldn't get the ball down," he said of early struggles. "That was the main thing and they took advantage of it."
After the Rays grabbed a 1-0 lead in the top of the first inning, Hellickson allowed four of the first five batters to reach base. Alejandro De Aza and Jeff Keppinger, the first two batters, each doubled to tie the score at 1. Following a walk to Alex Rios and a fly out by Adam Dunn, Paul Konerko drove in the second run with a single to left and Conor Gillaspie plated the third run with a sacrifice fly.
Hellickson then settled down and retired eight straight batters before issuing a one-out walk to Gillaspie in the fourth inning. Alexei Ramirez then followed with a double down the left-field line, but the Rays' defense bailed out Hellickson by throwing out Gillaspie with a perfect relay from left-fielder Desmond Jennings to third baseman Evan Longoria to catcher Jose Lobaton.
Hellickson averted further damage by striking out Tyler Flowers to end the fourth.
White Sox starter Chris Sale (2-2) also settled down after a shaky start, but Lobaton pulled the Rays to within 3-2 with a solo home run with two outs in the top of the fourth.
It was Lobaton's first homer of the season and the Rays dugout reacted by giving him the silent treatment.
"I didn't really care," he said of the lack of reaction. "I was happy. Everybody was kind of quiet, but that's not a big surprise on this team. Every day it's something different."
What was also different Thursday was Hellickson, who was coming off seven shutout innings against Oakland last week, getting smacked around at times. After cruising for four innings, Hellickson issued a leadoff walk to Rios in the sixth before Dunn followed with a line drive into the right-field bullpen to make it 5-2.
Hellickson called the offering to Dunn a "stupid pitch," but Maddon had his focus elsewhere in the sixth.
"I don't care about Dunn's home run," Maddon said. "It was the walk to Rios before that that set everything up. Otherwise, from the first inning to the home run, he pitched really, really well, and a lot like he did the previous two games."
Besides the first inning, Hellickson also has struggled to win on the road. He now is 0-5 despite a 3.24 ERA over his last seven road starts dating back to Aug. 15 last season.
"The second to the fifth inning was as good as I've thrown," he said. "Then in the sixth inning I walked the leadoff guy and made a pretty stupid pitch to Dunn. I settled down again after then, but it was too late by then."
Sale, who faced just one batter over the minimum in his final three innings, allowed two runs (both earned) on four hits in seven innings. Dunn said that's exactly what the White Sox expected after providing the cushion.
"Late in the game, you give Chris a three-run lead, we kind of like our chances," Dunn said. "It was good timing. We were able to keep it moving early and whenever you give your ace a lead early, you have a pretty good chance to win."
John Jackson is a contributor to MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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Last week I talked about the Freesound Project's great website for free samples. Shortly after I received an email from Tasos Frantzolas from Soundsnap.com. Tasos wanted to let me know about a similar site they have. When I traveled over to the site I realized I have been there before and even downloaded some sounds from it.
It's another good place to look for royalty free samples. It looks a bit more slick and up to date than the Freesound Project. One difference I notice is in the license Soundsnap samples come with.
– To remix or transform the sounds in any way
– To copy, distribute and transmit the sounds
– To use the sounds in any music, film, video game, website etc. whether commercial or not, without paying royalties or other fees
See that last one? You can use Soundsnap samples in commercial projects. The Freesound Project's Creative Commons license requires you to contact the sample owner if you want to use the sound commercially. Allthough I never had an issue with getting rights without any fee attached from Freesound Project members it worth noting.
Remember if you have some spare time to give back to these sites. A few samples from your old analog synths, a vocal here and there or grab one of the awesome new portable recorders that recently hit the market.
photo credit: troy -a life-


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In early 2009, Kyle and I became debt-free, and we vowed to never go in to debt again. By August of that year, we saved up a fully-funded, six-month emergency fund. That November, we went on a family vacation to Paris, the first time we had gone on a trip as a family, just for fun.
In the spring of 2010, we breathed a sigh of relief that we had that emergency fund, because we used almost every bit of it when we relocated back to the U.S. We saved it up again, and continued to save as we moved to Oregon, when we eventually put 30 percent down on a house with a 15-year fixed rate 3% mortgage.
We're now saving for our kids' college and retirement, and we hope to have our house paid off in the next few years.
I say all this not to brag. Quite the opposite—I'm bowled over at what all has happened, because neither Kyle nor I are natural "money people," nor are we millionaires. We've simply learned a lot the past few years, and put what we learned into practice.
Our teacher was Dave Ramsey, and our primary classroom was Financial Peace University. This is a nine lesson class that walks you through Money Management 101—you know, the stuff you wish you knew, but are sometimes too embarrassed to ask because you feel like you should already know it.
Stuff like writing a monthly budget, how to get out of debt, what all those different insurance terms mean, and how to buy a house sensibly. Some of the most important, freeing information you can know as an adult who wants to change her family tree.
See some highlights here:
You can also watch a preview of FPU.
FPU classes are all over the place, and if you're somewhere where they haven't yet reached, you can take the classes online (though it's a more impacting experience to take it with other people around you).
To celebrate the end of Home for the Holidays, I'm giving away FIVE Financial Peace University memberships. Once you're an alumni, you can always take the class again, so really, it's a lifelong gift.
Yes, this is a weird Christmas gift. But really? It's one of the best I can think of. If you apply what you learn, it will LITERALLY change your life. I'm honored to give it away today. Give it to someone you love, or keep it for yourself.
How to win
Simply use the widget below to leave a comment on this post, and you'll be entered to win! (If you're reading this via email, please click over to the main post to leave your comment.)
For extra entries, you can also follow Financial Peace and Dave Ramsey on Facebook—simply follow the steps in the widget below!
This giveaway will end tomorrow night, Saturday, December 1, and we'll announce the winners of all the holiday giveaways at the end of the week. I hope you're one of them!


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Santana's reunion with Halos marred by homers
Royals right-hander gives up four long balls in 7 2/3 innings
KANSAS CITY -- This was a natural. The Royals' Ervin Santana was going for his 100th career victory against his old club, the Angels. It was on the eighth anniversary of his first Major League victory, May 23, 2005.
Perfect scenario with an imperfect ending.
Santana gave up four home runs to Los Angeles, and the Angels won their fifth straight game, 5-4, on Thursday night at Kauffman Stadium. Since the Royals won two of three games against the Angels in Anaheim, they've lost six of seven.
This was the fourth time that Santana tried for victory No. 100. He probably needed to turn in what got him career win No. 1 against the White Sox, a shutout. But there was no scenario running in Santana's mind.
"I wasn't thinking about that," Santana said. "I just go up there and do my best. If it's going to happen, it's going to happen. If it's not, it's not."
The home runs were solo shots by Mike Trout, Albert Pujols and Chris Iannetta and then the killer, a two-run blast by Mark Trumbo.
"[Santana] throws a lot of strikes, and he's around the plate. He had his fastball up to 95 tonight, and these guys got a lot of power," manager Ned Yost said. "I thought Trout's home run was extremely impressive, for him to take a pitch down and drive it that far over the center-field fence as he did. And, of course, we all know what Albert Pujols could do with a pitch."
The first two blasts came from guys who have been especially troublesome for the Royals.
Trout, the young star who blasted two home runs against the Royals in Anaheim, connected again in the first inning -- and he went deep, deep to center field.
The Royals announced the ball traveled an estimated 433 feet when he hit the barrier under the scoreboard. ESPN later said its calculator estimated it to have gone 463 feet.
"Did they run out of tape to measure it? That ball was more than 430 feet," Angels manager Mike Scioscia said. "That thing was killed."
Pujols, whose long-term punishment of the Royals included 17 home runs, made it 18 when he led off the third inning. His shot into the left-field seats also was his 14th homer in 37 games at Kauffman Stadium, mostly with the Cardinals.
Perhaps it's Pujols' way of reminding folks that he grew up in Kansas City and played high school and college ball here.
Anyway, both homers came on fastballs.
"We had a plan coming in," Trout said. "We wanted to avoid chasing the sliders away and we stuck with the plan. We've been swinging it the past few days and you see what this offense can do."
Then, you know how it is, everybody wants to get into the act. Iannetta led off the Angels' fifth inning with a drive into the left-field bullpen.
Right-hander Joe Blanton, knocked around by the Royals in Anaheim, sailed through the first three innings and eventually got his first victory after seven defeats.
The Royals got single runs in the fourth and fifth innings, each started by a double (by Chris Getz and Lorenzo Cain, respectively) and scored on ground-ball outs.
But the Angels' lead ballooned to 5-2 in the eighth when Trumbo, on a 3-0 pitch from Santana, smashed a two-out, two-run homer. Afterward, Yost lamented not ordering ball four to Trumbo with first base open.
"Absolutely, that was a bad decision on my part," Yost said. "I'd tell you my thinking but it was a bad decision; yeah, that one was on me."
Santana dismissed the chance to throw ball four to Trumbo.
"I was just going to throw it right there," he said. "If he's going to swing, he's going to swing and we'll see what happens."
With Blanton out of the game and a parade of Angels relievers on display, the Royals made a game of it in the ninth inning.
"We definitely battled," Cain said. "We tried to pick up Santana. He definitely pitched a heck of a game today and we just tried to pick him up. Came together, came up a little short. That's how the ball bounces sometimes."
The way it bounced in the ninth inning against Angels closer Ernesto Frieri was Cain singled with one out, took second and scored on Salvador Perez's single, his third of the game. After a second out, pinch-hitter George Kottaras singled home pinch-runner David Lough. And when Frieri walked Getz, the Angels opted for rookie reliever Robert Coello.
Coello got Alcides Escobar to fly out and end the game.
"I thought we showed life at the end of the game," Yost said. "We've got a four-game set and the closer came in and had to throw close to 40 pitches in the first game so I thought we had a good approach. Anytime you can put the tying run at second base and the winning run at first base in the ninth inning, you've done something especially when you've been down three."
Even so, the Royals sustained their 12th loss by one run this season. And the fifth one-run loss in their last six.
Dick Kaegel is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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Inland Empire United Way has named Ontario-Montclair School District as the 2013 February Agency of the Month for its recent efforts to assist the community.
Over the past several years, Inland Empire United Way has partnered with Ontario-Montclair School District to help disadvantaged children and families in the district to receive much needed resources.
For several years, OMSD employees have supported IEUW through the annual employee giving campaign. This year, OMSD re-launched the campaign to benefit not only IEUW, but also the newly formed OMSD Foundation and the Promise Scholars program.
OMSD employees from the 33 school sites, administrative offices and other service departments raised more than $28,000, representing an increase of $15,000 from the previous year's campaign.
OMSD serves the cities of Ontario, Montclair, portions of Upland, and unincorporated areas of San Bernardino County. The District is the third largest elementary district in the State.


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'Think Sabres and you think a young team who can skate like the wind and throw the puck around as if it's on a string. Yesterday, they took a 3-2 series lead with a 3-0 win. They scored three goals that would be the centrepiece of an ad campaign for the new NHL. But ultimately that's not what won them the game. "I think their tenacity and hunger, not their speed, controlled the game," said Flyers coach Ken Hitchcock.'
You are here: Home / SabresBeat / Physical hockey still lives


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1" FNPT Red Brass 45 Degree Elbow
VALUE BRAND| Zoro #: G0634137| Mfr #: 1VEV1
Zoro #: G0634137Mfr. Part #: 1VEV1
$8.97 /ea
Orders over $50.00 ship free. DetailsStandard ground shipping
Technical Specifications
|Zoro #: G0634137 Mfr #: 1VEV1
|Basic Fitting Shape: Elbow
|Max. Pressure: 125 psi
|Temp. Range: -20 Degrees to 400 Degrees F
|Fitting Schedule/Class: Class 125
|Basic Fitting Material: Metal
|Pipe Fitting Material: Red Brass
|Fitting Connection Type: FNPT
|Standards: ASTM B584, ASME B16.15, ANSI B1.20.1
|Pipe Size (Fittings): 1"
|Specific Fitting Shape: 45 Degrees Elbow
|Item: Elbow, 45 Degrees
|Country of Origin (subject to change): China
Product Description
Elbow, 45 Degrees , Pipe Fitting Material Red Brass, Fitting Schedule/Class Class 125, Pipe Size (Fittings) 1 In., Fitting Connection Type FNPT, Standards ASTM B584, ASME B16.15, ANSI B1.20.1, Max. Pressure 125 psi, Temp. Range -20 Degrees to 400 Degrees F
Restrictions and Compliance
- *1 : California Proposition 65 : This product contains a chemical known to the State of California to cause birth defects or other reproductive harm.
- *2 : California Proposition 65 : This product contains a chemical known to the State of California to cause cancer.
- This product is not intended for potable water applications (human consumption – drinking and cooking) and has not been designed to be compliant with the "Safe Drinking Water Act" requirements for low lead in potable water applications. This item is for use, only, in non-potable (non-human consumption) water applications.
- ***
- This is a restricted item. It cannot be used in the USA for potable water applications.


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By clicking submit you agree to our T & CBook Now
You will receive your OTP on 9986293101Want to change your mobile no?
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"Wood work is quite a prevalent trend in the contemporary homes and as most of your furniture, beds and showpieces are engraved out of wood it is necessary that they should be properly taken care of from the harmful termites. These termites are a major threat on your wooden furniture and once they invade in your home the only option left for you is to go for anti-termite treatment. Book for termite control service via Gapoon and get professional help instantly."
We carry out a proper process of inspection of your home through checking the termite breeding. All the risk areas will be first checked and then a proper termite treatment will start. With the help of our expert professionals avail termite control services and get rid of termites instantly. Remember water is the major reason that breed termites.
Perfect service Took pest control service. Serviceman was on tym nd delivered the work perfectly.
NICE IDEA, Good starts, Thanks! Please Add more Cities ( Like Delhi, Mumbai, Pune, Kolkata, hyderabad, Chennai , Trivandrum). Then it will be use for all.
A really useful app Nicely structured app that helps take care of all home maintenance related emergencies. Must have app for those moments.
Explore our wide range of trending services and get acquainted with the array of pest control services that we provide through the help of our vendors. Our trending services are a right option for all your household problems. Check and choose the below-mentioned pest control services as per your requirement.


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You've suffered through snow storms and woolen sweaters, and finally, the reward for your patience is here. Summer has arrived—and with it, sunny afternoons perfect for get-togethers with friends and family.
So go ahead, fire up the grill, and rekindle your favorite summertime traditions or make new ones. With our invitation options, your summer events will be sure to get noticed.
Take a vacation from boring invites
For invitations with attitude, look no further than our summertime selections. Tiki torches hail a Hawaiian luau theme for your function. Or try the iconic barbeque grill to lure the hungry masses to your summer party. Perhaps a refreshing pool party will put your friends in the mood for summer fun. Looking for something a little more beachy? Brightly colored flip flops should do the trick.
Personalize designs for maximum "pop"
Now that you've picked your theme, you're ready to put your invites into action. You'll find everything you need for each design in the free Avery Design & Print Online Software. There's no download required, so it's easy to kick off all of your projects—all online!
Start with Avery Note Cards. With our simple online program, it's easy to personalize your invites with a special message for your guests.
Head next to the address labels. You can give the recipient a taste of what's to come with a small design from your chosen theme on every Avery Address Label you print. And we'll help you address them, too. Avery Design & Print Online gives you a step-by-step guide so you can mail merge your address list, or you can type them in one by one. If you don't have a spreadsheet with all of your names and addresses, you can start with our pre-formatted files for Microsoft® Excel or other database programs.
Even your return address labels can get in on the fun. Again, just go with your party theme and enter your address using the easy Avery Design Print Online Software. The unique look of these Avery Oval Labels, each printed with your chosen design, will help make your invitation stand out from the rest.
If you like the designs from Avery, you're welcome to use it as is. But remember that all Avery templates offer the freedom to customize your design with your own text and images. So go on and get creative.
Easy as apple pie
It's time to get the summer party season started! From start to finish, Avery Design and Print Online offers a quick and easy way to make unforgettable invites to your next summer shindig. There's no need to download any programs. So less time spent on invitations means more time for making the deviled eggs. Make summertime special with a little help from Avery.


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BOLTON'S top firefighter has issued a warning after a blaze — started by a candle — destroyed a bedroom at a house.
Flames were coming out of an upstairs window as fire crews arrived at the house in Glendale Drive, Ladybridge at 12.30am.
The family living at the property, including two adults and three grown-up children, as well as some family friends, had fled from the burning house unharmed.
Crews from Bolton Central fire station spent about 40 minutes putting out the fire.
The bedroom was destroyed but firefighters prevented flames spreading to the rest of the house.
It is thought that the blaze was started by a candle falling over.
Ian Bailey, Bolton borough manager, urged people to "keep their wits about them" if using candles.
He said: "All candles should be put out before people go to bed — this should be part of a bedroom routine.
"Candles should also be placed on a metallic base, so if they fall over, as is suspected in this case, there is less possibility of it igniting.
"We would also advise people to keep candles away from curtains and windows — we have also had reports of people placing candles on their baths, that is a definite no." Mr Bailey said he was not telling people to never use candles.
He added: "I know many people light candles as part of their cultural beliefs and we are not saying never do it, but if you are lighting them — just keep your wits about you."


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Thiotepa Followed by Peripheral Stem Cell or Bone Marrow Transplant in Treating Patients With Malignant Glioma
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
RATIONALE: Drugs used in chemotherapy work in different ways to stop tumor cells from dividing so they stop growing or die. Giving chemotherapy with peripheral stem cell or bone marrow transplant may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells.
PURPOSE: This phase II trial is studying how well thiotepa followed by peripheral stem cell or bone marrow transplant works in treating patients with malignant glioma.
|Brain and Central Nervous System Tumors
|Biological: filgrastim Biological: sargramostim Drug: cyclophosphamide Drug: thiotepa Procedure: autologous bone marrow transplantation Procedure: bone marrow ablation with stem cell support Procedure: peripheral blood stem cell transplantation
|Phase 2
|Study Type:
|Study Design:
|Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|CAMP 013:- Tandem Thiotepa Regimen For Selected Malignant Gliomas:1) Primary Or Recurrent Glioblastoma Multiforme (GBM); and 2) Recurrent Anaplastic Astrocytomas (AA), Oligodendrogliomas (O), Oligoastrocytomas (OA), Ependymomas And Primitive Neuroectodermal Tumors (PNET) That Have Either Progressed After Primary Therapy Or Are Refractory To Standard Chemotherapy
- Response rate
- Disease-free interval
- Overall survival
- Toxicity
- Pharmacokinetics
- Presence of high-dose thiotepa in the cerebrospinal fluid
|Estimated Enrollment:
|Study Start Date:
|September 1997
|Study Completion Date:
|May 2008
|Primary Completion Date:
|June 2005 (Final data collection date for primary outcome measure)
- Determine the response rate, disease-free interval, and overall survival of patients with malignant glioma treated with high-dose thiotepa followed by autologous peripheral blood stem cell transplantation.
- Determine the toxicity of this regimen in these patients.
- Determine the pharmacokinetics of this regimen in these patients.
- Determine whether this drug enters the cerebrospinal fluid of these patients.
OUTLINE: Following a course of induction chemotherapy with cyclophosphamide IV over 4 hours, patients receive filgrastim (G-CSF) daily until the completion of peripheral blood stem cell (PBSC) harvesting. PBSCs are collected over 3-5 days. Patients who do not mobilize sufficient cells undergo bone marrow harvest.
Patients receive high-dose thiotepa IV over 5 hours on day -2. PBSCs or bone marrow are reinfused on day 0. Patients receive sargramostim (GM-CSF) subcutaneously daily beginning on day 0 and continuing until blood counts recover. Treatment repeats every 2-3 weeks for a total of 1-4 courses in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed at baseline, at every course, then monthly for 6 months, and then every 2 months thereafter.
Patients are followed monthly for 6 months and then every 2 months thereafter.
PROJECTED ACCRUAL: A total of 5-40 patients will be accrued for this study within 3 years.
|Ages Eligible for Study:
|Child, Adult, Senior
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Histologically confirmed malignant glioma
- Primary or recurrent glioblastoma multiforme (including gliosarcoma) following surgery and radiotherapy or prior conventional chemotherapy (e.g., carmustine or procarbazine, vincristine, and lomustine)
- Recurrent or refractory anaplastic astrocytoma following any prior therapy (must be chemoresistant)
- Recurrent or refractory ependymoma or primitive neuroectodermal tumor (PNET) following any prior therapy
- Recurrent or refractory oligodendroglioma or oligoastrocytoma following any prior therapy (must be chemoresistant)
- Evaluable disease on gadolinium-enhanced MRI
- Ineligible for other high priority national or institutional study (e.g., protocol CAMP-004)
- Any age
Performance status:
Life expectancy:
- Not specified
- Not specified
- Not specified
- Creatinine less than 1.5 times normal
- LVEF at least 45% by MUGA
- DLCO at least 60% of predicted OR
- Approval by pulmonologist
- Not pregnant or nursing
- Fertile patients must use effective contraception
- HIV negative
Biologic therapy:
- Not specified
- See Disease Characteristics
- No other concurrent chemotherapy
Endocrine therapy:
- No concurrent anticancer hormonal therapy
- No concurrent steroids as antiemetics
- See Disease Characteristics
- See Surgery
- See Disease Characteristics
- For patients with glioblastoma multiforme, concurrent surgery and/or stereotactic radiosurgery to reduce tumor bulk allowed
- No concurrent acetaminophen during chemotherapy
Please refer to this study by its ClinicalTrials.gov identifier: NCT00008008
|United States, New Jersey
|St. Joseph's Hospital and Medical Center
|Paterson, New Jersey, United States, 07503
|United States, New York
|Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
|New York, New York, United States, 10032
|Study Chair:
|Charles S. Hesdorffer, MD
|Herbert Irving Comprehensive Cancer Center
|ClinicalTrials.gov Identifier:
|NCT00008008 History of Changes
|Other Study ID Numbers:
|Study First Received:
|January 6, 2001
|Last Updated:
|February 1, 2013
Keywords provided by National Cancer Institute (NCI):
adult anaplastic ependymoma
childhood infratentorial ependymoma
childhood supratentorial ependymoma
recurrent adult brain tumor
adult medulloblastoma
adult glioblastoma
adult oligodendroglioma
childhood high-grade cerebral astrocytoma
childhood oligodendroglioma
adult anaplastic astrocytoma
adult mixed glioma
recurrent childhood supratentorial primitive neuroectodermal tumor
recurrent childhood cerebellar astrocytoma
recurrent childhood cerebral astrocytoma
recurrent childhood ependymoma
adult giant cell glioblastoma
adult gliosarcoma
adult supratentorial primitive neuroectodermal tumor (PNET)
Additional relevant MeSH terms:
Nervous System Neoplasms
Central Nervous System Neoplasms
Neuroectodermal Tumors
Neuroectodermal Tumors, Primitive
Neoplasms, Neuroepithelial
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms by Site
Nervous System Diseases
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists
ClinicalTrials.gov processed this record on September 21, 2017


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Spotlight to Shine on Geographic Information Systems Nov. 14
Fairfax County Office of Public Affairs
12000 Government Center Parkway, Suite 551
Fairfax, VA 22035-0065
Contact: Merni Fitzgerald, Director of Public Affairs
703-324-3187, TTY 711, Fax 703-324-2010
Media Pager: 703-324-NEWS (6397)
Oct. 19, 2007
Spotlight to Shine on Geographic Information Systems Nov. 14
Fairfax County's Geographic Information Systems will be showcased on
Wednesday, Nov. 14, as part of a worldwide day of events. GIS, a
computer-based tool used to map and analyze features and events, combines
the power of a database with the visualization capabilities offered by
GIS Day activities in Fairfax County, which are free and open to the
public, will be held from 9 a.m. to 2 p.m. at the Fairfax County
Government Center, 12000 Government Center Parkway, Fairfax. Activities
will include award presentations; exhibits; live demonstrations of GIS
products, services and internal business processes; the GIS Excellence
Awards Map Gallery; and drawings for GIS Day T-shirts and hats.
The GIS Exhibit Hall in the Government Center's North Atrium will feature employees from 19 Fairfax County departments, including public schools, highlighting their use of GIS.
Board of Supervisors Chairman Gerald E. Connolly and Department of
Information Technology Director Wanda Gibson will recognize individual
county employees, teams and departments with GIS Excellence Awards at 11
a.m. Winners have used GIS to improve business processes, perform
geographic analysis, visualize projects, improve efficiency and
communicate with the public.
GIS Day is a global event during which users work to expand the
understanding of how GIS technology and geography make a difference.
Hundreds of thousands of people in the world use GIS to solve problems in
areas such as environmental protection, pollution, health care, land use,
asset deployment and routing, natural resources, conservation, business
efficiency, education and social inequities.
For more information on Fairfax County's GIS Day, visit www.fairfaxcounty.gov/maps/gisday.htm or call 703-324-4366, TTY 711.
For more news and information, visit www.fairfaxcounty.gov/news.


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Skip to Content
The University of Colorado Boulder Police Department is asking the public for help in identifying suspects involved in the Broadway underpass assault on August 23, 2013.
A composite sketch of one of the suspects, identified as Suspect #2 below, is shown here. Multiple witnesses confirmed that Suspect #2 left the scene with a bloody nose. An additional witness, who reportedly had contact with the suspects shortly after the assault, has told police the two suspects indicated that they are freshmen at CU.
Anyone who has information about this crime, or who believes they may know the identity of those involved, should contact CU Police at 303-492-6666.
The text of the original release follows:
The University of Colorado Boulder Police Department is investigating an aggravated assault which occurred at the Broadway / Euclid pedestrian underpass on the west side of the CU campus. At about 1:19 a.m. on August 23, 2013, CU Police responded to a report of an assault on the campus side of the pedestrian underpass.
According to witnesses, two male suspects approached a group of students and reportedly made derogatory statements including the fact that one of the individuals resembled a noted DJ and recording artist of Asian descent. A male CU student overhead the comment, intervened in the conversation, and punched one of the suspects. The two suspects proceeded to punch and kick the male student before fleeing to the east. The male CU student was transported to the hospital where it was determined that he suffered serious bodily injury to his face, including fractures and broken bones.
CU Police searched the area and were unable to locate the suspects. Witnesses provided the following description of the suspects:
Suspect #1
Suspect #2
The case number is 2013-1700.
Anyone with information about this crime should contact CU Police at 303-492-6666. Those who have information but wish to remain anonymous may contact the Northern Colorado Crime Stoppers at 1-800-222-TIPS (8477) or 1-800-444-3776. Tips can also be submitted via the Crime Stoppers website at http://www.crimeshurt.com. Those submitting tips through Crime Stoppers that lead to the arrest and filing of charges on a suspect(s) may be eligible for a cash reward of up to $1,000 from Crime Stoppers.
This message is being sent pursuant to the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, a federal law that requires colleges and universities that participate in federal financial aid programs to disclose major crime information to prospective and current students and employees. For more information on the Clery Act and CU-Boulder's policies, please see the campus' Annual Security and Fire Safety Report at www.colorado.edu/clery.


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Michigan Farm News reports The state Farm Bureau will provide science curriculum for seventh-grade classrooms in 38 Michigan school districts to counter a book used in classrooms teaching false opinions about agriculture.
"A hot planet needs cool kids" is a book used as a companion to the science curriculum with sources including Defenders of Wildlife, The Humane Society of the United States, and Wikipedia. Michigan Farm Bureau says those sources are bias and present false information as fact, misleading children as they shape views of agriculture.
The book includes a section encouraging children to eat less meat and says many livestock are kept in unnatural environments. The book adds eating less or no meat will reduce energy consumption, methane gas and the potential for disease outbreak.
Deb Schmucker, manager of Farm Bureau's Promotion and Education department, will prepare a packet of information for teachers to use educating students about sustainable, positive farm practices.
"The problem is, when these false statements are repeated over and over, they become engrained and are considered truth," Schmucker said. "If the teachers believe falsehood, and when school book writers use as resources other books and websites that contain falsehoods, where are the kids going to get the truth? If farmers need to write a textbook, we'll do it. But that's not the hard part. The hard part is getting it into the classroom."
Schmucker is working to have the book taken out of circulation.
For more information click here.
Source: Michigan Farm News


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DETROIT - We know to wash our hands and cover our mouths when we cough or sneeze, but what about the toothbrush, which visits the mouth several times per day? The mouth harbors all kinds of bacteria, so it's not surprising that bad bacteria can be easily transferred by a toothbrush.
Sarina Gleason, a Delta Dental spokesperson, appeared on Local 4 News Morning on Wednesday to discuss protecting your family so they don't get sick this winter.
Here are some tips from Delta Dental:
* Sterilize your toothbrush once per week. For manual toothbrushes, one minute in the microwave or one run through the dishwasher will do the trick. For electric toothbrushes, soak the head in mouthwash for 3 minutes.
* Avoid cross-contamination of germs by giving each member of the family their own tube of toothpaste and using an individual travel size container when someone is sick.
* Replace your toothbrush every four months because toothbrushes wear out and don't clean as effectively once the bristles become worn down. If you do get sick, be sure to replace your toothbrush right away.
* Wash your hands before and after brushing. Anytime the hands are near the mouth, they can transfer bacteria.


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"You know, it's going to be hard when mother dies," my mom confided to my big brother Roger recently. In the late stages of dementia, sometimes my mom thinks that Roger is her youngest brother Dexter, who died more than 25 years ago. Now in her 80s she still mourns for her mom and her little brother.
Dementia makes it possible for my mom to travel happily through time with her long passed brother and sadly, to prepare anew for her mother's death.
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BLUEBIRDS boss Nathan Rudge is hoping that his side's comeback against Bedworth United yesterday is a turning point in his side's season.
Chippenham found found themselves staring down the barrel at 2-0 down at half-time in Warwickshire but dug themselves out of a hole in the second period, with Lee Phillips scoring twice to earn a point.
Rudge was delighted with the character shown by his players.
"After the first-half and being 2-0 down, it felt like how many could we keep it to to be perfectly honest – we weren't playing well again," said the Bluebirds manager.
"But we had a word at half-time and the lads have responded brilliantly. After the second half, it's a game we probably should have won.
"We scored two good goals and had more chances and if there'd been another five or ten minutes, there was only one side that would have won it.
"Hopefully, that's the turning point of our season and to to come back from 2-0 shows a bit of character from the boys - one thing that we have got is fighting spirit.
"It keeps the gap between us and the other sides there and we've now got to go to Bashley and take the positives, which there are plenty of.
"We had some good performances today and I thought that the two lads that came in from Exeter (Jacob Wannell and Jordan Tillson) were outstanding.
"We've just got to keep grafting and hard work is the key at the minute – we've got good players but when you've had a bit of a slump, you've got to go back to basics."
Chippenham remain 16th in the Evo-Stik League Southern Premier Division and on Tuesday night, Rudge's men face another vital away trip when they travel to 19th-placed Bashley.


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Rumors aboard Mashape's spaceship
Nutritionix, the largest food database, joins Mashape
Morgan Davies
on March 17, 2014
It's not often we get to announce an API partnership that can directly improve your health and wellbeing. Mashape is excited to have
, the largest branded food database in the world, join our community. Nutritionix is a search engine and database for nutrition information. With over 300,000 unique food items you can browse or search by restaurants, as well as query specific food types to find nutritional information. The
Nutritionix API
allows you to access and integrate the functionality and data of Nutritionix to create new applications. The API provides nutritional facts to over 230,000 UPCs/barcodes, 100,000 restaurant…
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