Faculty Bibliography

BACKGROUND/BACKGROUND:Type 2 diabetes mellitus has been associated with an excess risk of pancreatic cancer, but the magnitude of the risk and the time-risk relationship are unclear, and there is limited information on the role of antidiabetic medications. PATIENTS AND METHODS/METHODS:We analyzed individual-level data from 15 case-control studies within the Pancreatic Cancer Case-Control Consortium, including 8305 cases and 13 987 controls. Pooled odds ratios (ORs) were estimated from multiple logistic regression models, adjusted for relevant covariates. RESULTS/RESULTS:Overall, 1155 (15%) cases and 1087 (8%) controls reported a diagnosis of diabetes 2 or more years before cancer diagnosis (or interview, for controls), corresponding to an OR of 1.90 (95% confidence interval, CI, 1.72-2.09). Consistent risk estimates were observed across strata of selected covariates, including body mass index and tobacco smoking. Pancreatic cancer risk decreased with duration of diabetes, but a significant excess risk was still evident 20 or more years after diabetes diagnosis (OR 1.30, 95% CI 1.03-1.63). Among diabetics, long duration of oral antidiabetic use was associated with a decreased pancreatic cancer risk (OR 0.31, 95% CI 0.14-0.69, for ≥15 years). Conversely, insulin use was associated with a pancreatic cancer risk in the short term (OR 5.60, 95% CI 3.75-8.35, for <5 years), but not for longer duration of use (OR 0.95, 95% CI 0.53-1.70, for ≥15 years). CONCLUSION/CONCLUSIONS:This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows that a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease the risk of pancreatic cancer, whereas insulin showed an inconsistent duration-risk relationship.

Prediction of surgical flap survival in a dog model was evaluated by using the technique of fluorometry. The model provides a graded variation of flap ischemia with tissue necrosis occurring at the distal end. The indicator sodium fluorescein was administered via the saphenous vein at a constant infusion rate for 20 minutes. Quantitative fluorescence measurements were obtained with surface illumination of the flap at 132 sites for 15 flaps in the five animals. Wash-in slopes and wash-out clearances, both measures of tissue perfusion, were compared with the survival of flap regions observed at seven days. The sensitivity and specificity of fluorometric wash-in and wash-out measurements were compared in their ability to predict flap survival. The study showed sensitivities of 100% and 95% and specificities of 97% and 86%, respectively for the two methods. The wash-in procedure with constant infusion may be preferable to the wash-out technique since it requires less time to complete. In addition, it avoids bolus injections thus reducing the risk of anaphylactoid reactions

Sixteen patients with serious Gram-negative bacillary infections were treated with intravenous ceftazidime, 2 g every 8 h. The majority of patients had bacteraemia or pneumonitis or both. Ten patients were cured and six improved. Seven of ten patients infected with Pseudomonas aeruginosa were cured, and three improved. No adverse reactions occurred. Four strains of Ps. aeruginosa became resistant to ceftazidime in patients who were cured or improved clinically. Ceftazidime is effective as single drug therapy for serious Gram-negative infections, including those due to Ps. aeruginosa

Virgin female Buffalo strain (BUF) rats that were treated with methylcholanthrene (MC) had a higher incidence of lymphocytic thyroiditis than untreated BUF rats. The degree of infiltration was also greater in MC-treated rats. The incidence of thyroiditis in retired breeder female BUF rats approached that found in MC-treated rats. The susceptibility to the effect of MC was not expressed in most F-1 hybrids of BUF and Lewis (LEW), a strain of rat that does not develop thyroiditis after treatment with MC