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PubMed2005

Palm glucose readings compared with fingertip readings under steady and dynamic glycemic conditions, using the OneTouch Ultra Blood Glucose Monitoring System.

OBJECTIVES: Past studies have suggested the absence of lag between palm glucose and fingertip glucose, even when glucose levels are changing rapidly. However, at any given time point, there may be differences between palm and fingertip glucose values because of glycemic instability and/or test methodology. The objectives of this study included assessing the variability in fingertip blood glucose test results between two fingers, and establishing whether the variability in blood glucose test results obtained from the palm was clinically equivalent to that observed in fingertip-to-fingertip comparisons. METHODS: This multicenter trial was conducted on patients under both steady-state glycemic conditions and after meal and exercise challenges (to promote rapidly changing glucose). Sequential capillary glucose testing, performed with the One Touch Ultra Blood Glucose Monitoring System (LifeScan, Inc., Milpitas, CA), was allocated to two of four fingertip sites and one of two palm sites in each subject using a randomized, balanced, incomplete block design. One of the fingertips was designated the reference site. Fingertip-to-fingertip variability and fingertip- to-palm variability were assessed under these steady-state and dynamic testing conditions using error grid analysis and by comparing the proportion of clinically acceptable blood glucose tests at the palm site versus the fingertip site. Clinically acceptable agreement was defined as pairs of values (fingertip to reference, or palm to reference) within 15 mg/dL when reference glucose was < or = 75 mg/dL or within 20% when reference glucose was >75 mg/dL. RESULTS: One hundred eighty-one subjects with type 1 [n = 74 (40.9%)] or type 2 [n = 107 (59.1%)] diabetes at eight clinical sites completed the study. Overall, the proportion of clinically acceptable agreement was high for both palm (95.1%) and fingertip (97.5%) testing. The mean difference between palm and fingertip clinically acceptable agreement when done by healthcare professionals was -1.3% and -4.4%, under steady-state and dynamic glycemic conditions, respectively. Error grid analysis showed >97% of all palm and fingertip measurements fell in Zone A. CONCLUSION: This study demonstrated that variability between fingertip-to-fingertip and palm-to-fingertip measurements was in the clinically acceptable range during steady-state conditions and when glucose was rapidly changing.

Adolescent↗
PubMed1995

Comparison of single reading with double reading of mammograms, and change in effectiveness with experience.

In the prevalence round of screening for breast cancer at a single centre, the benefit of the second radiological report has been assessed using data from 33,734 women, their screening results and knowledge of the interval cancers. The service was set up under the UK National Breast Screening Programme, and the data show evidence of learning by both individuals and the team as a whole. Of the 269 cancers detected by screening, 33 would not have been diagnosed if the only report available had been the first. The recall recommendation rate associated with the first report was 6.9% and 236 cancers were detected. The recall recommendation rate associated with all queries of all the reports was 10% (3354 queries). Had these 3354 queries all been investigated (instead of the 1423 actually recalled) only a further three cancers would have been detected. Sensitivity of the programme as a whole was substantially better than that of individual radiologists, while the specificity was maintained. The decision pathway by which recalls were agreed between the two radiologists resulted in a low recall rate (4.2%) for the programme as a whole, and is a critical factor in gaining the benefit of the improved sensitivity without a concomitant deterioration in the specificity. With the passage through the prevalent round, recall rates steadily fell, the malignant to benign biopsy ratio improved and sensitivity increased. The second radiological report yielded 14% additional cancers diagnosed and contributed very significantly to good sensitivity and so to the effectiveness of screening. Economic analysis of the results will be reported in a further paper.

Breast Neoplasms↗
PubMed1998

Reading "glasses" will prime "vision," but reading a pair of "glasses" will not.

In a lexical decision task with two primes and a target, the target was preceded 300 msec by the second prime (P2) which in turn was preceded by a brief forward and backward masked first prime (P1). When P1 and P2 were unrelated, reaction times were faster when the target was related to P2 (e.g., wave SALT ... pepper) than when the target was unrelated to P2 (and P1--e.g., wave LOAN ... pepper). However, this semantic priming effect was reduced to statistically nonsignificant levels when P1 and P2 were repetitions of the same word. That is, priming did not occur for salt SALT ... pepper relative to loan LOAN ... pepper. This reduction in priming was observed whether P2 and the target were strongly or weakly related. These findings raise problems for current accounts of semantic priming.

Cognition↗
PubMed2003

By the way, doctor. When I was first diagnosed with hypertension, my doctor (who knew that I was a competitive cyclist) prescribed an ACE inhibitor. I wondered for some time why he didn't prescribe diuretics, since all the articles I've read recommend that as a beginning step. Then I read in a bicycling magazine that ACE inhibitors are the only hypertension medicine that doesn't interfere with aerobic performance. Is that true? And did my doctor do the right thing?

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Angiotensin-Converting Enzyme Inhibitors↗