Diabetes-Associated Changes in Cortical Auditory-Evoked Potentials in Relation to Normal Aging.

Objectives: (1) To characterize the influence of type 2 diabetes mellitus (DM) on cortical auditory-evoked potentials (CAEPs) separate from the effects of normal aging, and (2) to determine whether the disease-related effects are modified by insulin dependence.

Design: A cross-sectional study was conducted in a large cohort of Veterans to investigate the relationships among type 2 DM, age, and CAEPs in randomly selected participants with (N = 108) and without (N = 114) the disease and who had no more than a moderate hearing loss. Participants with DM were classified as insulin-dependent (IDDM, N = 47) or noninsulin-dependent (NIDDM, N = 61).

Hearing Impairment in Relation to Severity of Diabetes in a Veteran Cohort.

Objective: Type 2 diabetes is epidemic among veterans, approaching three times the prevalence of the general population. Diabetes leads to devastating complications of vascular and neurologic malfunction and appears to impair auditory function. Hearing loss prevention is a major health-related initiative in the Veterans Health Administration.

Waiting time predicts survival after liver transplantation for hepatocellular carcinoma: a cohort study using the United Network for Organ Sharing registry.

Recipients of liver transplantation (LT) for hepatocellular carcinoma (HCC) have an 8% to 20% risk of HCC recurrence. Single-center studies suggest that a period of waiting after HCC therapy may facilitate the selection of patients at low risk for post-LT HCC recurrence and mortality. We evaluated whether a longer waiting time after Model for End-Stage Liver Disease (MELD) prioritization for HCC predicts longer post-LT survival.

Age-related changes in the auditory brainstem response.

Purpose: This cross-sectional study had two goals: (1) Identify and quantify the effects of aging on the auditory brainstem response (ABR); (2) Describe how click rate and hearing impairment modify effects of aging. RESEARCH DESIGN AND ANALYSIS: ABR measures were obtained from 131 predominately male Veteran participants aged 26 to 71 yr. Metrics analyzed include amplitude and latency for waves I, III, and V, and the I-V interpeak latency interval (IPI) at three repetition rates (11, 51, and 71 clicks/sec) using both polarities.

Audiometric thresholds and prevalence of tinnitus among male veterans in the United States: data from the National Health and Nutrition Examination Survey, 1999-2006.

Hearing loss and tinnitus are the two most prevalent service-connected disabilities among U.S. veterans.

The reliability of diagnostic coding and laboratory data to identify tuberculosis and nontuberculous mycobacterial disease among rheumatoid arthritis patients using anti-tumor necrosis factor therapy.

Purpose: Anti-tumor necrosis factor-alpha (anti-TNF) therapies are associated with severe mycobacterial infections in rheumatoid arthritis patients. We developed and validated electronic record search algorithms for these serious infections.

Methods: The study used electronic clinical, microbiologic, and pharmacy records from Kaiser Permanente Northern California (KPNC) and the Portland Veterans Affairs Medical Center (PVAMC).

Distortion-product otoacoustic emission test performance for ototoxicity monitoring.

Introduction: A nonbehavioral method for monitoring ototoxicity in patients treated with cisplatin is needed because patients enduring chemotherapy may not be well or cooperative enough to undergo repeated hearing tests. Distortion-product otoacoustic emissions (DPOAEs) provide a nonbehavioral measure of auditory function that is sensitive to cisplatin exposure. However, interpreting DPOAE findings in the context of ototoxicity monitoring requires that their accuracy be determined in relation to a clinically accepted gold standard test.

Adjuvant therapy and survival after resection of pancreatic adenocarcinoma: a population-based analysis.

Background: The use of adjuvant chemoradiation for pancreatic adenocarcinoma (PAC) is accepted in North America, but there is a paucity of data to support this practice. The relation between adjuvant therapy and survival was assessed in a population-based cohort of patients with PAC.

Methods: A review was conducted of all cases of resected PAC from 1996 to 2003 using data from the state cancer registry augmented with data from primary medical record review.

Diabetes-related changes in auditory brainstem responses.

Objectives/hypothesis: Determine effects on auditory brainstem response (ABR) of diabetes mellitus (DM) severity.

Study Design: A cross-sectional study investigating DM severity and ABR in military Veteran subjects with (166) and without (138) DM and with no more than moderate hearing loss.

Methods: Subjects were classified by three age tertiles (<50, 50-56, and 57+).

Diabetes-related changes in hearing.

Objectives/hypothesis: Determine the effects on hearing of diabetes mellitus (DM) severity.

Study Design: We conducted a cross-sectional study among Veterans to investigate the relationship of diabetes severity and hearing in randomly selected subjects with (165) and without (137) DM and who had no more than a moderate hearing loss.

Methods: Subjects were classified by three age tertiles (<50, 50-56, and 57+ years).

Incremental lifetime cancer risks computed for benzo[a]pyrene and two tobacco-specific N-nitrosamines in mainstream cigarette smoke compared with lung cancer risks derived from epidemiologic data.

The manner in which humans smoke cigarettes is an important determinant of smoking risks. Of the few investigators that have predicted cancer risks from smoking on a chemical-specific basis, most used mainstream cigarette smoke (MCS) carcinogen emissions obtained via machine smoking protocols that only approximate human smoking conditions. Here we use data of Djordjevic et al.

Evolving preoperative evaluation of patients with pancreatic cancer: does laparoscopy have a role in the current era?

Background: Recent years have brought important developments in preoperative imaging and use of laparoscopic staging of patients with pancreatic adenocarcinoma (PAC). There are few data about the optimal combination of preoperative studies to accurately identify resectable patients.

Study Design: We conducted a statewide review of all patients with surgically managed PAC from 1996 to 2003 using data from the Oregon State Cancer Registry, augmented with clinical information from primary medical record review.

Incidence and prevalence of uveitis in Veterans Affairs Medical Centers of the Pacific Northwest.

Purpose: To ascertain the frequency of uveitis in Veterans Affairs (VA) patients in the Pacific Northwest and to compare disease rates with those in previously published epidemiologic studies.

Design: Cross-sectional, population based-study.

Methods: The medical records of 152,267 patients seen at six VA Medical Centers in Oregon and Washington during fiscal year 2004 were searched for uveitis-related International Classification of Diseases 9th edition codes.

The View-Master Health Study Focus Groups.

Trichloroethylene (TCE), a common groundwater contaminant, was found at high levels at an Oregon work site in 1998. According to a recent report released by the National Research Council, "the evidence on carcinogenic risk and other health hazards from exposure to trichloroethylene has strengthened since 2001." A convenience sample of 13 former workers from the Oregon work site was recruited for a series of focus groups.

Detection and description of small breast masses by residents trained using a standardized clinical breast exam curriculum.

Objectives: We evaluated the effect of standardized clinical breast examination (CBE) training on residents' ability to detect a 3-mm breast mass in a silicone breast model.

Methods: In this nonrandomized controlled trial, 75 first year residents (R1s) at 8 family medicine, internal medicine, and obstetrics and gynecology training programs received the intervention and second year residents (R2s) did not. Trained residency faculty taught R1s vertical strip, three-pressure method (VS3PM) CBE using a standardized curriculum, including a 1- to 2-hour online self-study with video and 2.

The association between advertising and calls to a tobacco quitline.

Objective: This study assessed the cost effectiveness of different types of television and radio advertisements and the time of day in which advertisements were placed in generating calls to the Oregon tobacco quitline.

Design: Cost effectiveness was measured by cost per call, calculated as the cost of advertising divided by the number of quitline calls generated by that advertising. Advertising was bought in one-week or two-week blocks and included 27 daytime television buys, 22 evening television buys and 31 radio buys.

Calculated cancer risks for conventional and "potentially reduced exposure product" cigarettes.

Toxicant deliveries (by machine smoking) are compiled and associated cancer risks are calculated for 13 carcinogens from 26 brands of conventional cigarettes categorized as "regular" (R), "light" (Lt), or "ultralight" (ULt), and for a reference cigarette. Eight "potentially reduced exposure product" (PREP) cigarettes are also considered. Because agency-to-agency differences exist in the cancer slope factor (CSF) values adopted for some carcinogens, two CSF sets were used in the calculations: set I [U.

A mid year comparison study of career satisfaction and emotional states between residents and faculty at one academic medical center.

Background: The Accreditation Council for Graduate Medical Education's (ACGME) new requirements raise multiple challenges for academic medical centers. We sought to evaluate career satisfaction, emotional states, positive and negative experiences, work hours and sleep among residents and faculty simultaneously in one academic medical center after implementation of the ACGME duty hour requirements.

Methods: Residents and faculty (1330) in the academic health center were asked to participate in a confidential survey; 72% of the residents and 66% of the faculty completed the survey.

Review of case-control studies related to breastfeeding and reduced risk of childhood leukemia.

Objective: To conduct a systematic review to evaluate the evidence for the effect of breastfeeding on the risk of developing childhood leukemia.

Review Methods: We sought studies providing data regarding the association of breastfeeding and occurrence of childhood leukemia. Studies were identified by using Medline, HHS Blueprint for Action on Breastfeeding, US Department of Health and Human Services Office on Women's Health, Cochrane Database of Systematic Reviews, National Centre for Reviews and Dissemination, reference lists, and national experts.

Recursive partitioning for risk stratification in men undergoing repeat prostate biopsies.

Background: The current study was performed to identify risk factors and risk groups for carcinoma detection in men undergoing repeat prostate biopsies.

Methods: The medical records of all men who had a negative initial prostate biopsy and underwent at least one repeat biopsy between 1992 and 2003 were reviewed to extract age, race, family history of prostate carcinoma, body mass index, referral indication, all prostate-specific antigen (PSA) values, digital rectal examination, PSA density (PSAD), the presence of a hypoechoic lesion, and the presence of high-grade prostatic intraepithelial neoplasia (HGPIN) on initial biopsy. Risk factors for a subsequent diagnosis of prostate carcinoma were identified using the log-rank test and a stepwise, stratified Cox regression model.

Stages of smoking acquisition versus susceptibility as predictors of smoking initiation in adolescents in primary care.

We evaluated whether susceptibility, the stages of smoking acquisition, and socio-environmental factors can identify adolescents who will become smokers. Our data came from a randomized controlled trial of an intervention to prevent adolescent smoking. Subjects were adolescents (n=1955) ages 14-17 being seen for routine medical care.

Structured clinical breast examination (CBE) training results in objective improvement in CBE skills.

Background: A statewide breast cancer care provider needs assessment had identified CBE training as a target educational need. Accordingly, the authors implemented a one-on-one skills-based course for primary care providers (PCPs) across the state.

Method: The course had two components: a prerequisite self-study manual, followed by a 1 1/2-hour skills-based practicum.