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Near-normoglycaemic remission in African-Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function
SUMMARY Aims To prospectively determine the frequency of remission and possible mechanism of beta cell recovery in non‐Whites with Type 2 diabetes mellitus in the setting of intensive glycaemic regulation using pharmacological agents. Methods Twenty‐six consecutive, newly diagnosed African‐America...
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| Published in: | Diabetic medicine 2001-01, Vol.18 (1), p.10-16 |
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| container_title | Diabetic medicine |
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| creator | McFarlane, S. I. Chaiken, R. L. Hirsch, S. Harrington, P. Lebovitz, H. E. Banerji, M. A. |
| description | SUMMARY
Aims To prospectively determine the frequency of remission and possible mechanism of beta cell recovery in non‐Whites with Type 2 diabetes mellitus in the setting of intensive glycaemic regulation using pharmacological agents.
Methods Twenty‐six consecutive, newly diagnosed African‐American, Type 2 diabetic patients presenting primarily for severe hyperglycaemia (31.0 ± 12.8 mmol/l) were followed for at least 1 year. Initial hospitalization included treatment with insulin, fluids and electrolytes. Outpatient intensive glycaemic regulation included insulin or glibenclamide, diabetes education and diet that altered nutrient content. Plasma glucose and C‐peptide responses to an oral glucose tolerance test and HbA1c were measured at |
| doi_str_mv | 10.1046/j.1464-5491.2001.00395.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70605037</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70605037</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4305-34a7178b04732fdae2f0cfcdc04ce2e2b981f7a3054e0efac6d6143644d7ecc53</originalsourceid><addsrcrecordid>eNqNkEFv0zAYhi0EYmXjLyBLSNwS7NiJE4lLKVuHNMYOmybtYrnOZ3BJ4s5OWHPll-MsVblysT_Jz-vXfhDClKSU8OLjNqW84EnOK5pmhNCUEFbl6f4FWhwPXqIFETxLGBH0BL0JYRvBrGLVa3RCKS1KxvIF-nMNyied86370YxaQWs19nENwboO2w4vjbdadcmyhech4Cfb_8S34w5whmurNtBDwC00je2HgG3AKgSnreqhnlkP2v0GP2JncKQV1hHGZuh0H0vO0CujmgBvD_spurs4v11dJlff119Xy6tEc0byhHElqCg3hAuWmVpBZog2utaEa8gg21QlNUJFlAMBo3RRF5SzgvNagNY5O0Uf5nt33j0OEHoZfzm9RHXghiAFKUhOmIhgOYPauxA8GLnztlV-lJTIyb_cykmznDTLyb989i_3Mfru0DFsWqj_BQ_CI_D-AKigVWO86rQNR64seVZO1KeZerINjP9dL798O49DjCdz3IYe9se48r9kIZjI5f31Wj6sLy_u89WN_Mz-AtivsfM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70605037</pqid></control><display><type>article</type><title>Near-normoglycaemic remission in African-Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>McFarlane, S. I. ; Chaiken, R. L. ; Hirsch, S. ; Harrington, P. ; Lebovitz, H. E. ; Banerji, M. A.</creator><creatorcontrib>McFarlane, S. I. ; Chaiken, R. L. ; Hirsch, S. ; Harrington, P. ; Lebovitz, H. E. ; Banerji, M. A.</creatorcontrib><description>SUMMARY
Aims To prospectively determine the frequency of remission and possible mechanism of beta cell recovery in non‐Whites with Type 2 diabetes mellitus in the setting of intensive glycaemic regulation using pharmacological agents.
Methods Twenty‐six consecutive, newly diagnosed African‐American, Type 2 diabetic patients presenting primarily for severe hyperglycaemia (31.0 ± 12.8 mmol/l) were followed for at least 1 year. Initial hospitalization included treatment with insulin, fluids and electrolytes. Outpatient intensive glycaemic regulation included insulin or glibenclamide, diabetes education and diet that altered nutrient content. Plasma glucose and C‐peptide responses to an oral glucose tolerance test and HbA1c were measured at < 14, 15–56 and 57–112 days after presentation. Remission was defined as a HbA1c ≤ 6.3% and fasting plasma glucose < 6.9 mmol/l, 3 months after discontinuing all pharmacological agents.
Results Eleven of 26 patients (42.3%) developed remission after a mean of 83 days of pharmacological treatment and remained in remission during follow‐up for 248–479 days; one relapsed after 294 days. Fifteen patients who did not develop a remission and were followed for 168–468 days, required continuing pharmacological therapy to be well‐controlled. (mean HbA1c = 7.1%). There was no significant difference in age, sex, plasma glucose at presentation, initial glycaemic regulation, final body mass index, magnitude of weight change or pharmacological agents used for treatment between the two groups. Plasma C‐peptide response to oral glucose was initially (< 14 days) suppressed in all subjects and subsequently increased. The increase was significantly greater in those who underwent a remission than those who did not. Neither significant weight loss nor severe hypoglycaemia was observed in either group during intensive treatment.
Conclusions Forty‐two per cent of newly diagnosed, unselected African‐Americans with Type 2 diabetes, treated intensively using pharmacological agents, education and diet developed near‐normoglycaemic remission. Remission was associated with a greater recovery of glucose‐stimulated insulin secretion suggesting that therapies directed at promoting beta cell recovery and preservation are potentially useful approaches to the treatment of Type 2 diabetes mellitus.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1046/j.1464-5491.2001.00395.x</identifier><identifier>PMID: 11168335</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>African Americans ; African Continental Ancestry Group ; Aged ; beta cell recovery ; Biological and medical sciences ; Biomarkers - blood ; Blood Glucose - metabolism ; C-Peptide - blood ; C-Peptide - metabolism ; Combined Modality Therapy ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes Mellitus, Type 2 - therapy ; Diabetes. Impaired glucose tolerance ; Diet, Diabetic ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Female ; Follow-Up Studies ; Glyburide - therapeutic use ; Glycated Hemoglobin A - analysis ; Humans ; Hyperglycemia ; Hypoglycemic Agents - therapeutic use ; Insulin - blood ; Insulin - metabolism ; Insulin - therapeutic use ; Insulin Secretion ; Islets of Langerhans - physiopathology ; Male ; Management. Various non-drug treatments. Langerhans islet grafts ; Medical sciences ; Middle Aged ; New York City ; Patient Education as Topic ; Prospective Studies ; remission ; Time Factors ; treatment ; type 2 diabetes</subject><ispartof>Diabetic medicine, 2001-01, Vol.18 (1), p.10-16</ispartof><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4305-34a7178b04732fdae2f0cfcdc04ce2e2b981f7a3054e0efac6d6143644d7ecc53</citedby><cites>FETCH-LOGICAL-c4305-34a7178b04732fdae2f0cfcdc04ce2e2b981f7a3054e0efac6d6143644d7ecc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4022,27922,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=884285$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11168335$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McFarlane, S. I.</creatorcontrib><creatorcontrib>Chaiken, R. L.</creatorcontrib><creatorcontrib>Hirsch, S.</creatorcontrib><creatorcontrib>Harrington, P.</creatorcontrib><creatorcontrib>Lebovitz, H. E.</creatorcontrib><creatorcontrib>Banerji, M. A.</creatorcontrib><title>Near-normoglycaemic remission in African-Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>SUMMARY
Aims To prospectively determine the frequency of remission and possible mechanism of beta cell recovery in non‐Whites with Type 2 diabetes mellitus in the setting of intensive glycaemic regulation using pharmacological agents.
Methods Twenty‐six consecutive, newly diagnosed African‐American, Type 2 diabetic patients presenting primarily for severe hyperglycaemia (31.0 ± 12.8 mmol/l) were followed for at least 1 year. Initial hospitalization included treatment with insulin, fluids and electrolytes. Outpatient intensive glycaemic regulation included insulin or glibenclamide, diabetes education and diet that altered nutrient content. Plasma glucose and C‐peptide responses to an oral glucose tolerance test and HbA1c were measured at < 14, 15–56 and 57–112 days after presentation. Remission was defined as a HbA1c ≤ 6.3% and fasting plasma glucose < 6.9 mmol/l, 3 months after discontinuing all pharmacological agents.
Results Eleven of 26 patients (42.3%) developed remission after a mean of 83 days of pharmacological treatment and remained in remission during follow‐up for 248–479 days; one relapsed after 294 days. Fifteen patients who did not develop a remission and were followed for 168–468 days, required continuing pharmacological therapy to be well‐controlled. (mean HbA1c = 7.1%). There was no significant difference in age, sex, plasma glucose at presentation, initial glycaemic regulation, final body mass index, magnitude of weight change or pharmacological agents used for treatment between the two groups. Plasma C‐peptide response to oral glucose was initially (< 14 days) suppressed in all subjects and subsequently increased. The increase was significantly greater in those who underwent a remission than those who did not. Neither significant weight loss nor severe hypoglycaemia was observed in either group during intensive treatment.
Conclusions Forty‐two per cent of newly diagnosed, unselected African‐Americans with Type 2 diabetes, treated intensively using pharmacological agents, education and diet developed near‐normoglycaemic remission. Remission was associated with a greater recovery of glucose‐stimulated insulin secretion suggesting that therapies directed at promoting beta cell recovery and preservation are potentially useful approaches to the treatment of Type 2 diabetes mellitus.</description><subject>African Americans</subject><subject>African Continental Ancestry Group</subject><subject>Aged</subject><subject>beta cell recovery</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - metabolism</subject><subject>C-Peptide - blood</subject><subject>C-Peptide - metabolism</subject><subject>Combined Modality Therapy</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diet, Diabetic</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glyburide - therapeutic use</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin - blood</subject><subject>Insulin - metabolism</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Secretion</subject><subject>Islets of Langerhans - physiopathology</subject><subject>Male</subject><subject>Management. Various non-drug treatments. Langerhans islet grafts</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>New York City</subject><subject>Patient Education as Topic</subject><subject>Prospective Studies</subject><subject>remission</subject><subject>Time Factors</subject><subject>treatment</subject><subject>type 2 diabetes</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqNkEFv0zAYhi0EYmXjLyBLSNwS7NiJE4lLKVuHNMYOmybtYrnOZ3BJ4s5OWHPll-MsVblysT_Jz-vXfhDClKSU8OLjNqW84EnOK5pmhNCUEFbl6f4FWhwPXqIFETxLGBH0BL0JYRvBrGLVa3RCKS1KxvIF-nMNyied86370YxaQWs19nENwboO2w4vjbdadcmyhech4Cfb_8S34w5whmurNtBDwC00je2HgG3AKgSnreqhnlkP2v0GP2JncKQV1hHGZuh0H0vO0CujmgBvD_spurs4v11dJlff119Xy6tEc0byhHElqCg3hAuWmVpBZog2utaEa8gg21QlNUJFlAMBo3RRF5SzgvNagNY5O0Uf5nt33j0OEHoZfzm9RHXghiAFKUhOmIhgOYPauxA8GLnztlV-lJTIyb_cykmznDTLyb989i_3Mfru0DFsWqj_BQ_CI_D-AKigVWO86rQNR64seVZO1KeZerINjP9dL798O49DjCdz3IYe9se48r9kIZjI5f31Wj6sLy_u89WN_Mz-AtivsfM</recordid><startdate>200101</startdate><enddate>200101</enddate><creator>McFarlane, S. I.</creator><creator>Chaiken, R. L.</creator><creator>Hirsch, S.</creator><creator>Harrington, P.</creator><creator>Lebovitz, H. E.</creator><creator>Banerji, M. A.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200101</creationdate><title>Near-normoglycaemic remission in African-Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function</title><author>McFarlane, S. I. ; Chaiken, R. L. ; Hirsch, S. ; Harrington, P. ; Lebovitz, H. E. ; Banerji, M. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4305-34a7178b04732fdae2f0cfcdc04ce2e2b981f7a3054e0efac6d6143644d7ecc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>African Americans</topic><topic>African Continental Ancestry Group</topic><topic>Aged</topic><topic>beta cell recovery</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - metabolism</topic><topic>C-Peptide - blood</topic><topic>C-Peptide - metabolism</topic><topic>Combined Modality Therapy</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diet, Diabetic</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glyburide - therapeutic use</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin - blood</topic><topic>Insulin - metabolism</topic><topic>Insulin - therapeutic use</topic><topic>Insulin Secretion</topic><topic>Islets of Langerhans - physiopathology</topic><topic>Male</topic><topic>Management. Various non-drug treatments. Langerhans islet grafts</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>New York City</topic><topic>Patient Education as Topic</topic><topic>Prospective Studies</topic><topic>remission</topic><topic>Time Factors</topic><topic>treatment</topic><topic>type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McFarlane, S. I.</creatorcontrib><creatorcontrib>Chaiken, R. L.</creatorcontrib><creatorcontrib>Hirsch, S.</creatorcontrib><creatorcontrib>Harrington, P.</creatorcontrib><creatorcontrib>Lebovitz, H. E.</creatorcontrib><creatorcontrib>Banerji, M. A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McFarlane, S. I.</au><au>Chaiken, R. L.</au><au>Hirsch, S.</au><au>Harrington, P.</au><au>Lebovitz, H. E.</au><au>Banerji, M. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Near-normoglycaemic remission in African-Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2001-01</date><risdate>2001</risdate><volume>18</volume><issue>1</issue><spage>10</spage><epage>16</epage><pages>10-16</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>SUMMARY
Aims To prospectively determine the frequency of remission and possible mechanism of beta cell recovery in non‐Whites with Type 2 diabetes mellitus in the setting of intensive glycaemic regulation using pharmacological agents.
Methods Twenty‐six consecutive, newly diagnosed African‐American, Type 2 diabetic patients presenting primarily for severe hyperglycaemia (31.0 ± 12.8 mmol/l) were followed for at least 1 year. Initial hospitalization included treatment with insulin, fluids and electrolytes. Outpatient intensive glycaemic regulation included insulin or glibenclamide, diabetes education and diet that altered nutrient content. Plasma glucose and C‐peptide responses to an oral glucose tolerance test and HbA1c were measured at < 14, 15–56 and 57–112 days after presentation. Remission was defined as a HbA1c ≤ 6.3% and fasting plasma glucose < 6.9 mmol/l, 3 months after discontinuing all pharmacological agents.
Results Eleven of 26 patients (42.3%) developed remission after a mean of 83 days of pharmacological treatment and remained in remission during follow‐up for 248–479 days; one relapsed after 294 days. Fifteen patients who did not develop a remission and were followed for 168–468 days, required continuing pharmacological therapy to be well‐controlled. (mean HbA1c = 7.1%). There was no significant difference in age, sex, plasma glucose at presentation, initial glycaemic regulation, final body mass index, magnitude of weight change or pharmacological agents used for treatment between the two groups. Plasma C‐peptide response to oral glucose was initially (< 14 days) suppressed in all subjects and subsequently increased. The increase was significantly greater in those who underwent a remission than those who did not. Neither significant weight loss nor severe hypoglycaemia was observed in either group during intensive treatment.
Conclusions Forty‐two per cent of newly diagnosed, unselected African‐Americans with Type 2 diabetes, treated intensively using pharmacological agents, education and diet developed near‐normoglycaemic remission. Remission was associated with a greater recovery of glucose‐stimulated insulin secretion suggesting that therapies directed at promoting beta cell recovery and preservation are potentially useful approaches to the treatment of Type 2 diabetes mellitus.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>11168335</pmid><doi>10.1046/j.1464-5491.2001.00395.x</doi><tpages>7</tpages></addata></record> |
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| subjects | African Americans African Continental Ancestry Group Aged beta cell recovery Biological and medical sciences Biomarkers - blood Blood Glucose - metabolism C-Peptide - blood C-Peptide - metabolism Combined Modality Therapy Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - physiopathology Diabetes Mellitus, Type 2 - therapy Diabetes. Impaired glucose tolerance Diet, Diabetic Endocrine pancreas. Apud cells (diseases) Endocrinopathies Female Follow-Up Studies Glyburide - therapeutic use Glycated Hemoglobin A - analysis Humans Hyperglycemia Hypoglycemic Agents - therapeutic use Insulin - blood Insulin - metabolism Insulin - therapeutic use Insulin Secretion Islets of Langerhans - physiopathology Male Management. Various non-drug treatments. Langerhans islet grafts Medical sciences Middle Aged New York City Patient Education as Topic Prospective Studies remission Time Factors treatment type 2 diabetes |
| title | Near-normoglycaemic remission in African-Americans with Type 2 diabetes mellitus is associated with recovery of beta cell function |
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