Through a survey 751 patients, in whom an endoscopic papillotomy (EPT) had been tried, were registered to the end of 1981. EPT was technically successful in 695 cases (92,5%). Control investigations were available for 650 patients, the aim of therapy being achieved in 594 cases (91,4%). The main indication was choledocholithiasis, 90,2%--among them 10% with gallbladder in situ--followed by benign papillary stenosis without stones (5,9%), carcinoma of the Vaterian papilla (3,2%) and rare indications such as ascaridiasis, choledochocele and stones of the pancreatic duct (0,7%). 53 patients suffered from more serious complications (7,6%), 18 had to be operated on (2,6%), and 7 patients died due to EPT (1%). The results are in agreement with those of other statistics from various countries.
OBJECTIVES/GOALS: The impact of baseline BMI on glycemic response to group medical visits (GMV) and weight management (WM)-based interventions is unclear. Our objective is to determine how baseline BMI class impacts patient responses to GMV and interventions that combine WM/GMV. METHODS/STUDY POPULATION: We will perform a secondary analysis of Jump Start, a randomized, controlled trial that compared the effectiveness of a GMV-based low carbohydrate diet-focused WM program (WM/GMV) to traditional GMV-based medication management (GMV) on diabetes control. The primary and secondary outcomes will be change in hemoglobin A1c (HbA1c) and weight at 48 months, respectively. Study participants will be stratified into BMI categories defined by BMI 27-29.9kg/m 2 , 30.0-34.9kg/m 2 , 35.0-39.9kg/m 2 , and ≥40.0kg/m 2 . Hierarchical mixed models will be used to examine the differential impact of the WM/GMV intervention compared to GMV on changes in outcomes by BMI class category. RESULTS/ANTICIPATED RESULTS: Jump Start enrolled 263 overweight Veterans (BMI ≥ 27kg/m 2 ) with type 2 diabetes. At baseline, mean BMI was 35.3 and mean HbA1c was 9.1. 14.5% were overweight (BMI 27–29.9) and 84.5% were obese (BMI ≥ 30). The proposed analyses are ongoing. We anticipate that patients in the higher BMI obesity classes will demonstrate greater reductions in HbA1c and weight with the WM/GMV intervention relative to traditional GMV. DISCUSSION/SIGNIFICANCE OF IMPACT: This work will advance the understanding of the relationship between BMI and glycemic response to targeted interventions, and may ultimately provide guidance for interventions for type 2 diabetes.
Diabetes distress (DD), the psychological distress specific to living with diabetes, is associated with poor glycemic control. This study sought to examine the association of diabetes distress with demographic, clinical, and psychosocial factors in a vulnerable population. The Diabetes Distress Scale (DDS), a validated patient questionnaire that assesses perceived problems and burdens associated with diabetes management, yields a total diabetes stress score plus 4 subscale scores: emotional burden (EB), physician distress (PD), regimen distress (RD) and interpersonal distress (ID). We conducted a cross-sectional analysis of baseline data from a randomized telehealth trial in a population of Veterans with persistently poor T2DM control (HbA1c ≥8.5) (N= 248). Multivariable linear regression models were used with baseline patient characteristics as independent variables and DD score as the dependent variable, and separate models for the 4 subscales of the DDS were created. Mean age of the cohort was 58 years (SD 8.3); 21% of patients were female, 79% non-white with 14 being Latinx/Hispanic. Prevalence of moderate to severe DD was 37.5% (mean DDS 1.19 (SD 0.82). In the multivariable model, Latinx/Hispanic ethnicity β 0.4 (95% CI: .01, 0.8) and higher HbA1c 0.1 (.01, 1.3) were associated with higher total DD. With respect to the DDS subscales, higher HbA1c 0.14 (0.1, 0.2) was associated with higher RD. Latinx/Hispanic ethnicity 0.8 (0.2, 1.3) was associated with higher ID. Use of basal insulin was associated with higher PD 0.3 (.001, 0.6). Depression was associated with higher total DD 0.1 (0.1, 0.1), EB 0.1 (0.1, 0.1), PD .02 (.001, 0.1), RD 0.1 (0.1, 0.1) and ID .05 (0.03, 0.1). The knowledge gained from this study has implications for practice, particularly in developing interventions targeting modifiable barriers, including patient attitudes and beliefs regarding treatment regimens and diagnoses and treatment of depression. Disclosure J. German: None. E. A. Kobe: None. D. Soliman: None. A. Lewinski: Consultant; Self; Otsuka America Pharmaceutical, Inc., Other Relationship; Self; PhRMA Foundation. A. S. Jeffreys: None. C. Coffman: None. D. Edelman: None. M. J. Crowley: None.
A next generation tomosynthesis (NGT) system has been proposed to obtain higher spatial resolution than traditional digital breast tomosynthesis (DBT) by achieving consistent sub-pixel resolution. Resolution and linear acquisition artifacts can be further improved by creating multi-axis, x-ray tube acquisition paths. This requires synchronization of the x-ray generator, x-ray detector, and motion controller for an x-ray tube motion path composed of arbitrarily spaced x-ray projection points. We have implemented a state machine run on an Arduino microcontroller that synchronizes the system processes through hardware interrupts. The desired x-ray projection points are converted into two-dimensional motion segments that are compiled to the motion controller's memory. The state machine then signals the x-ray tube to move from one acquisition point to another, exposing x-rays at each point, until every acquisition is made. The effectiveness of this design was tested based on speed of procedure and image quality metrics. The results show that the average procedure time, over 15 test runs for three different paths, took under 20 seconds, which is far superior to previous acquisition methods on the NGT system. In conclusion, this study shows that a state machine implementation is viable for fast and accurate acquisitioning in NGT systems.
