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Andrea Cherrington - One of the best experts on this subject based on the ideXlab platform.
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optimization of metformin in the grade Cohort Effect on glycemia and body weight
Diabetes Care, 2020Co-Authors: William I Sivitz, Lawrence S Phillips, Deborah J Wexler, Stephen P Fortmann, Anne W Camp, Margaret Tiktin, Magalys Perez, Jacqueline E Craig, P Hollander, Andrea CherringtonAbstract:OBJECTIVE We evaluated the Effect of optimizing metformin dosing on glycemia and body weight in type 2 diabetes. RESEARCH DESIGN AND METHODS This was a prespecified analysis of 6,823 participants in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) taking metformin as the sole glucose-lowering drug who completed a 4- to 14-week (mean ± SD, 7.9 ± 2.4) run-in in which metformin was adjusted to 2,000 mg/day or a maximally tolerated lower dose. Participants had type 2 diabetes for RESULTS Adjusted for duration of run-in, the mean ± SD change in HbA1c was −0.65 ± 0.02% (−7.1 ± 0.2 mmol/mol) when the dose was increased by ≥1,000 mg/day, −0.48 ± 0.02% (−5.2 ± 0.2 mmol/mol) when the dose was unchanged, and −0.23 ± 0.07% (−2.5 ± 0.8 mmol/mol) when the dose was decreased (n = 2,169, 3,548, and 192, respectively). Higher HbA1c at entry predicted greater reduction in HbA1c (P CONCLUSIONS Optimizing metformin to 2,000 mg/day or a maximally tolerated lower dose combined with emphasis on medication adherence and lifestyle can improve glycemia in type 2 diabetes and HbA1c values ≥6.8% (51 mmol/mol). These findings may help guide efforts to optimize metformin therapy among persons with type 2 diabetes and suboptimal glycemic control.
Mirdad Kazanji - One of the best experts on this subject based on the ideXlab platform.
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Absence of intrafamilial transmission of hepatitis C virus and low risk for sexual transmission in rural central Africa indicate a Cohort Effect.
J Clin Virol, 2009Co-Authors: Guy-roger Ndong-atome, Richard Njouom, Cindy Padilla, Ulrick Bisvigou, Maria Makuwa, Mirdad KazanjiAbstract:BACKGROUND: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being debated, and little is known about such transmission in central Africa. OBJECTIVE: To examine the rate of intrafamilial transmission of HCV between patients and their household members. STUDY DESIGN: A cross-sectional study was conducted in Dienga, a remote village in Gabon, involving 195 household members of 14 index cases of HCV infection. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for antibody to HCV by an enzyme immunoassay (Monolisa anti-HCV plus version 2). Positive samples were tested for HCV RNA and genotyped by amplification and phylogenetic analysis of a fragment of the NS5B gene. RESULTS: HCV antibody was found in 13/195 (6.7%) household contacts, comprising 5/14 (35.7%) sexual partners and 8/114 (7%) relatives. None of the children of index patients tested positive. HCV RNA was detected in only five household members with HCV antibody. The same genotypes were found in only two of five couples, both couples being sexual partners. Parenteral risk factors were not more likely to be reported by people positive for HCV antibody than by those who were negative. Age over 50 years was the only independent predictor of positivity for HCV antibody. CONCLUSIONS: This study indicates, as previously suggested, that the spread of HCV in central Africa is due to a Cohort Effect, with previous, possibly iatrogenic, transmission rather than intrafamilial or sexual transmission.
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Absence of intrafamilial transmission of hepatitis C virus and low risk for sexual transmission in rural central Africa indicate a Cohort Effect
Journal of Clinical Virology, 2009Co-Authors: Guy-roger Ndong-atome, Richard Njouom, Cindy Padilla, Ulrick Bisvigou, Maria Makuwa, Mirdad KazanjiAbstract:Background: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being debated, and little is known about such transmission in central Africa. Objective: To examine the rate of intrafamilial transmission of HCV between patients and their household members. Study design: A cross-sectional study was conducted in Dienga, a remote village in Gabon, involving 195 household members of 14 index cases of HCV infection. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for antibody to HCV by an enzyme immunoassay (Monolisa anti-HCV plus version 2). Positive samples were tested for HCV RNA and genotyped by amplification and phylogenetic analysis of a fragment of the NS5B gene. Results: HCV antibody was found in 13/195 (6.7%) household contacts, comprising 5/14 (35.7%) sexual partners and 8/114 (7%) relatives. None of the children of index patients tested positive. HCV RNA was detected in only five household members with HCV antibody. The same genotypes were found in only two of five couples, both couples being sexual partners. Parenteral risk factors were not more likely to be reported by people positive for HCV antibody than by those who were negative. Age over 50 years was the only independent predictor of positivity for HCV antibody. Conclusions: This study indicates, as previously suggested, that the spread of HCV in central Africa is due to a Cohort Effect, with previous, possibly iatrogenic, transmission rather than intrafamilial or sexual transmission.
R A Feldman - One of the best experts on this subject based on the ideXlab platform.
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the Cohort Effect and helicobacter pylori
The Journal of Infectious Diseases, 1993Co-Authors: Nicholas Banatvala, K Mayo, F Megraud, R Jennings, Jonathan J Deeks, R A FeldmanAbstract:Abstract A total of 631 serum samples collected in 1969, 1979, and 1989 from adults and children were screened for Helicobacter pylori by Western blot analysis. Results showed that H. pylori seroprevalence has become less frequent over the 20-year period. By studying seropositivity by year of birth, the magnitude of a Cohort Effect of H. pylori seropositivity was estimated. The odds of being seropositive decreased by 26% per decade, P = .008 (95% confidence interval, 8%-41%). Estimates of seroprevalence adjusted for both age-specific variation and the Cohort Effect suggest that most seropositivity in adults occurs by the age of 15 years. The implication of these findings is that H. pylori infection is becoming less frequent and is predominantly acquired in childhood.
Richard Njouom - One of the best experts on this subject based on the ideXlab platform.
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Absence of intrafamilial transmission of hepatitis C virus and low risk for sexual transmission in rural central Africa indicate a Cohort Effect.
J Clin Virol, 2009Co-Authors: Guy-roger Ndong-atome, Richard Njouom, Cindy Padilla, Ulrick Bisvigou, Maria Makuwa, Mirdad KazanjiAbstract:BACKGROUND: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being debated, and little is known about such transmission in central Africa. OBJECTIVE: To examine the rate of intrafamilial transmission of HCV between patients and their household members. STUDY DESIGN: A cross-sectional study was conducted in Dienga, a remote village in Gabon, involving 195 household members of 14 index cases of HCV infection. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for antibody to HCV by an enzyme immunoassay (Monolisa anti-HCV plus version 2). Positive samples were tested for HCV RNA and genotyped by amplification and phylogenetic analysis of a fragment of the NS5B gene. RESULTS: HCV antibody was found in 13/195 (6.7%) household contacts, comprising 5/14 (35.7%) sexual partners and 8/114 (7%) relatives. None of the children of index patients tested positive. HCV RNA was detected in only five household members with HCV antibody. The same genotypes were found in only two of five couples, both couples being sexual partners. Parenteral risk factors were not more likely to be reported by people positive for HCV antibody than by those who were negative. Age over 50 years was the only independent predictor of positivity for HCV antibody. CONCLUSIONS: This study indicates, as previously suggested, that the spread of HCV in central Africa is due to a Cohort Effect, with previous, possibly iatrogenic, transmission rather than intrafamilial or sexual transmission.
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Absence of intrafamilial transmission of hepatitis C virus and low risk for sexual transmission in rural central Africa indicate a Cohort Effect
Journal of Clinical Virology, 2009Co-Authors: Guy-roger Ndong-atome, Richard Njouom, Cindy Padilla, Ulrick Bisvigou, Maria Makuwa, Mirdad KazanjiAbstract:Background: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being debated, and little is known about such transmission in central Africa. Objective: To examine the rate of intrafamilial transmission of HCV between patients and their household members. Study design: A cross-sectional study was conducted in Dienga, a remote village in Gabon, involving 195 household members of 14 index cases of HCV infection. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for antibody to HCV by an enzyme immunoassay (Monolisa anti-HCV plus version 2). Positive samples were tested for HCV RNA and genotyped by amplification and phylogenetic analysis of a fragment of the NS5B gene. Results: HCV antibody was found in 13/195 (6.7%) household contacts, comprising 5/14 (35.7%) sexual partners and 8/114 (7%) relatives. None of the children of index patients tested positive. HCV RNA was detected in only five household members with HCV antibody. The same genotypes were found in only two of five couples, both couples being sexual partners. Parenteral risk factors were not more likely to be reported by people positive for HCV antibody than by those who were negative. Age over 50 years was the only independent predictor of positivity for HCV antibody. Conclusions: This study indicates, as previously suggested, that the spread of HCV in central Africa is due to a Cohort Effect, with previous, possibly iatrogenic, transmission rather than intrafamilial or sexual transmission.
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Hepatitis C virus infection in cameroon: A Cohort-Effect.
Journal of Medical Virology, 2005Co-Authors: Eric Nerrienet, Régis Pouillot, Guillaume Lachenal, Richard Njouom, Jermie Mfoupouendoun, Catherine Bilong, Philippe Mauclère, Christophe Pasquier, Ahidjo AyoubaAbstract:A hepatitis C virus (HCV) serological study conducted in 2003 on 1,434 individuals in Yaounde and other HCV seroepidemiological studies on 2,066 sera sampled between 1993 and 1997 in four geographically distinct rural areas (Ntem, Mekas, Yokadouma, and Nditam) in Cameroon, are described. Two patterns of HCV seroprevalence were observed. The first pattern, represented by Nditam and Yokadouma populations, showed low HCV seroprevalence rates (2.9% and 3.3%, respectively) increasing moderately with age (9.0% and 16.7% after age 50). The second pattern showed high seroprevalence rates (6.9% for Yaounde, 14.4% and 16.7% for Ntem and Mekas, respectively). These rates increased dramatically with age (32.8%–49.5% after age 50). The age-specific anti-HCV prevalence curve of the 1993 Mekas survey paralleled those of the 1997 Ntem and 2003 Yaounde surveys. Using the year of birth as the x-axis, the three curves closely matched each other. This clearly indicates a Cohort Effect for which the seroprevalence trends are clearly related with the year of birth, rather than the age. The highest prevalence was observed among people born around 1940. J. Med. Virol. 76:208–214, 2005. © 2005 Wiley-Liss, Inc.
William I Sivitz - One of the best experts on this subject based on the ideXlab platform.
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optimization of metformin in the grade Cohort Effect on glycemia and body weight
Diabetes Care, 2020Co-Authors: William I Sivitz, Lawrence S Phillips, Deborah J Wexler, Stephen P Fortmann, Anne W Camp, Margaret Tiktin, Magalys Perez, Jacqueline E Craig, P Hollander, Andrea CherringtonAbstract:OBJECTIVE We evaluated the Effect of optimizing metformin dosing on glycemia and body weight in type 2 diabetes. RESEARCH DESIGN AND METHODS This was a prespecified analysis of 6,823 participants in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) taking metformin as the sole glucose-lowering drug who completed a 4- to 14-week (mean ± SD, 7.9 ± 2.4) run-in in which metformin was adjusted to 2,000 mg/day or a maximally tolerated lower dose. Participants had type 2 diabetes for RESULTS Adjusted for duration of run-in, the mean ± SD change in HbA1c was −0.65 ± 0.02% (−7.1 ± 0.2 mmol/mol) when the dose was increased by ≥1,000 mg/day, −0.48 ± 0.02% (−5.2 ± 0.2 mmol/mol) when the dose was unchanged, and −0.23 ± 0.07% (−2.5 ± 0.8 mmol/mol) when the dose was decreased (n = 2,169, 3,548, and 192, respectively). Higher HbA1c at entry predicted greater reduction in HbA1c (P CONCLUSIONS Optimizing metformin to 2,000 mg/day or a maximally tolerated lower dose combined with emphasis on medication adherence and lifestyle can improve glycemia in type 2 diabetes and HbA1c values ≥6.8% (51 mmol/mol). These findings may help guide efforts to optimize metformin therapy among persons with type 2 diabetes and suboptimal glycemic control.