Barbara A Cunningham | PubMed Health

PubMed2006

Effectiveness of a screening program for hepatitis C.

We sought to determine the outcomes of a screening program for hepatitis C virus (HCV) infection. Of 536 veterans initially screened between July 2000 and June 2001 for risk factors and then tested positive for antibody for HCV, only 260 (48.5%) kept their initial appointments for further evaluation; 51 were not viremic and only 19 (9.1%) were treatment eligible. Of the 276 who did not keep their initial appointments, 92 were subsequently evaluated over the next 2 years and 23 (25%) were treatment eligible, along with another 15 from the first group. Thus, with appropriate intervention and long-term follow-up, there were 57 treatment candidates. In conclusion, most veterans who tested positive either failed to keep their appointment or were ineligible for treatment when first evaluated. Over the following 2 years, some were lost to follow-up, many continued to have contraindication(s) to antiviral therapy, and relatively few were treatment candidates.

Adult↗

PubMed2003

Glucagon-like peptide 1 and fatty acids amplify pulsatile insulin secretion from perifused rat islets.

Glucose-induced insulin secretion from isolated, perifused rat islets is pulsatile with a period of about 5-10 min, similar to the insulin oscillations that are seen in healthy humans but which are impaired in Type II diabetes. We evaluated the pattern of enhancement by the potent incretin, glucagon-like peptide 1 (GLP-1). GLP-1 increased the amplitude of pulses and the magnitude of insulin secretion from the perifused islets, without affecting the average time interval between pulses. Forskolin and the phosphodiesterase inhibitor isobutylmethylxanthine had the same effect, suggesting that the effect was due to elevated cAMP levels. The possibility that cAMP might enhance the amplitude of pulses by reducing phosphofructo-2-kinase (PFK-2) activity was eliminated when the liver isoform of PFK-2 was shown to be absent from beta-cells. The possibility that cAMP enhanced pulsatile secretion, at least in part, by stimulating lipolysis was supported by the observations that added oleate had a similar effect on secretion, and that the incretin effect of GLP-1 was inhibited by the lipase inhibitor orlistat. These data show that the physiological incretin GLP-1 preserves and enhances normal pulsatile insulin secretion, which may be essential in proposed therapeutic uses of GLP-1 or its analogues.

1-Methyl-3-isobutylxanthine↗