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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The development of insulin-dependent diabetes mellitus is thought to be related to environmental trigger factors acting upon a background of genetic predisposition to the disease. Viral infections, toxins, and dietary factors are being considered as trigger factors. The authors studied the relationship of the development of diabetes from birth up to 15 years of age to the type of feeding in infancy, childhood infections, and vaccination among 55 patients attending Endocrinology Clinics of the Ethio-Swedish Children's and Tikur Anbessa Hospitals over the period January 1990 to December 1991. 74 unaffected siblings and 107 unrelated individuals were included as controls. No significant difference was found in relation to type of feeding up to the ages of three, six, and twelve months or older between patients and unaffected siblings. Histories of measles, chicken pox, and whooping cough were equally distributed between the two groups. The introduction of bottle-feeding, however, was significantly more frequent among unrelated controls at three months and six months of age. The use of cow's milk and other formulas in bottle-feeding showed a significant negative association with the development of diabetes. An history of vaccination against tuberculosis, measles, diphtheria, pertussis, tetanus, and polio was significantly more common among unrelated controls than diabetics. There was no significant difference in family history of diabetes in first degree relatives, parental education, and level of income between diabetics and unrelated controls. The authors suggest that more extensive studies are warranted.
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PMID:The relation of early nutrition, infections and socio-economic factors to the development of childhood diabetes. 783 52

The inner city population of the Los Angeles county has rapidly become largely Latino. The 3.3 million Latinos living in the county in 1990 had much higher poverty rates and lower educational attainment rates than Anglo (non-Hispanic white) or blacks. The health indicators of the three groups are compared for 1990. In birth outcome, although Latinos were the least likely to receive care in the first trimester, Latinos and Anglos had identical rates of low birth weight babies, and lower rates than blacks. Latino infant mortality was the lowest of the three. The age-adjusted death rates showed that Latinos have a lower overall death rate than Anglos or blacks, and lower specific rates for heart disease, cancer, AIDS and stroke. Latinos did have higher death rates than Anglos for accidents, homicides, cirrhosis and diabetes. Latinos had incidence rates of gonorrhoea and syphilis similar to Anglos and lower than blacks. The communicable disease rates for Latinos was many times higher than Anglos or blacks, including those for measles, shigellosis, giardiasis and hepatitis A. Implications for family medicine are discussed.
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PMID:Latino health in Los Angeles: family medicine in a changing minority context. 784 24

The "Health Transition" describes the medical consequences which accompany the demographic transition and development. In many Asian countries, as the infectious diseases of infancy decline, such as diarrhea, acute respiratory disease, measles and malaria, so too, do infant mortality rates. As a consequence of falling infant mortality rates and declines in fertility, the age pyramid has become more rectangular. No longer is nearly half of the population under the age of 15 years. Diseases of adults are beginning to become predominant: trauma, heart disease, cancer, stroke and diabetes. Life expectancy has increased along with costs of the health care system. As a fraction of per capita gross domestic product, health care is beginning to become a major national expense. It is ironic that the one vector-borne infectious disease likely to bridge the health transition in tropical countries is dengue. As evidenced by the experience of Singapore and Taiwan, modern housing and commercial development provide more, rather than fewer breeding places for Aedes aegypti. Greater affluence often means less compliance with mosquito control programs. Meanwhile, the dengue viruses, heeding some unknown genetic imperative, cause ever more severe disease. Modern Asian societies must count dengue as a real and enduring threat. To prevent costly hospitalizations and a sense of social disorder, effective measures must be adopted to achieve a significant reduction of Aedes aegypti populations. Sustained dengue control requires source reduction which, in turn depends upon imaginative leadership, skilled man power, legislative authority, an authentic national research program and intersectoral cooperation. A leadership role beckons for new actors in the control of Aedes aegypti: large municipalities, environmental agencies and the private sector.
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PMID:Dengue in the health transition. 784 46

Mumps-measles-rubella vaccination-induced antibody responses were studied in Type 1 diabetic children to find out the possible aberrations in mumps antibody responsiveness previously seen after natural mumps in Type 1 diabetic children. Mumps, measles, and rubella virus antibodies were studied in 364 newly diagnosed Type 1 diabetic subjects, their 240 non-diabetic siblings and 59 age- and sex-matched, unrelated, non-diabetic control subjects who all had received mumps-measles-rubella vaccine but had not had the respective infections. Sera were collected from all children at the time of the diagnosis of diabetes in the index case which was on average 2.5 years after the mumps-measles-rubella vaccination. The levels of IgG class mumps virus antibodies were lower in diabetic patients than in their non-diabetic siblings (p < 0.0005). This difference was most pronounced in males as male patients had significantly lower IgG mumps antibody levels than female patients. Rubella and measles IgG antibodies did not differ between patients and control subjects. The results are in accordance with previous studies suggesting a selective decrease in mumps antibody levels in Type 1 diabetic children. As the exposure to mumps virus had been exactly the same in all study groups, low mumps antibodies in diabetic children suggest decreased responsiveness rather than different number of past infections in these patients.
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PMID:Low mumps antibody levels induced by mumps-measles-rubella vaccinations in type 1 diabetic children. 789 58

In order to investigate a possible viral aetiology for Type 1 diabetes the polymerase chain reaction (PCR) technique was used. Pancreatic tissue from Type 1 diabetic subjects was examined for the presence of a panel of common viruses. Primers specific for mumps, measles, cytomegalovirus, and Epstein Barr virus, as well as primers located in a highly conserved region of the enterovirus genome which are capable of detecting all of the following family members: Coxsackie B, echovirus, polio, mengovirus, and encephalomyocarditis virus were used to screen 18 Type 1 diabetic subjects of whom 3 had proven insulitis, 12 Type 2 diabetic subjects and 18 non-diabetic controls. Epstein Barr virus was detected in two Type 1 (13%), two Type 2 (22%), and three of the normal nondiabetic pancreases (20%), and the DNA sequences confirmed by direct sequencing. Cytomegalovirus was detected in one of the normal pancreases only and no evidence of any of the other viruses was found. It is concluded that the Type 1 diabetic pancreatic samples studied did not show persistence of infection with any of the above viruses. Non-persistent acute infection of the pancreas by the above viruses cannot be excluded in the aetiology of Type 1 diabetes from this study.
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PMID:A search for candidate viruses in type 1 diabetic pancreas using the polymerase chain reaction. 795 73

Some epidemiological aspects of Paget's disease were examined using questionnaires completed by 864 patients with physician-diagnosed Paget's disease and 500 controls of similar ages. Specifically studied were issues of familial aggregation of the disorder, history of exposure to certain infectious diseases, other medical disorders, and calcium intake (as assessed by milk consumption) in childhood. A history of Paget's disease in a first-degree relative was noted in 12% of patients and 2% of controls. Among patients, those with a positive family history had an earlier mean age at diagnosis and a greater prevalence of bone deformity than patients with a negative family history. The risk of a first-degree relative of a pagetic patient developing Paget's disease was 7 times greater than the risk of an individual without such a relative, and the cumulative risk to age 90 for a first-degree relative of a patient was 9%, compared with a 2% risk in a person without affected relatives. The risk to the relative was greatest if the patient had an age at diagnosis of less than 55 years and had deforming bone disease. There was no difference between patients and controls for a variety of viral infections, including measles, and no difference in ownership of dogs and possible exposure to canine viruses. Diabetes was more common in controls than in patients, but arthritis, skeletal fractures, primary hyperparathyroidism, osteoporosis, and thyroid disease (in women) and renal stones (in men) were reported more commonly by patients. Milk consumption during childhood and adolescence was lower in patients than in controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiological aspects of Paget's disease: family history and relationship to other medical conditions. 800 30

At 20 weeks amenorrhoea, it is currently possible to determine with echocardiography whether a fetal heart, which then weighs approximately 400g with a diameter of 15 mm, is normal or not. The incidence of cardiac malformations has been estimated at 8 per 1000 fetuses. Fetal factors including retarded growth, hydramnios and arrhythmia and maternal factors including rubeola, diabetes, systemic lupus erythematosus, Rhesus incompatibility and drugs increase fetal risk. In certain cardiopathies such as aortic stenosis, coarctation, malformation of the mitral valve or left ventricle hypoplasia, the risk of recurrence in a second fetus is greatly increased. With 2D echocardiography, the apical section of the four heart cavities orients the heart in the thorax, identifies the atria and ventricles and visualizes valve movement. The origin of the aorta and the kinetics of the mitral and aortic valves are studied on the para-sternal section. TM mode reproduces the P-QRS sequence thus allowing a measurement of heart rate, the thicknesses of heart walls and septa and identifies conduction disorders. The transvalvular systolic pressures can be measured with Doppler echocardiography and pulsed Doppler quantifies blood flow through the different heart structures. Precision can be increased with colour coding. A complete echocardiography of the fetal heart should be an integral part of all examinations of fetal morphology. Usually performed between 22 and 32 weeks of amenorrhoea, echocardiography of the fetal heart requires a perfect understanding of two-dimensional Doppler modes and of three-dimensional representation of heart anatomy.
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PMID:[Fetal echocardiography. The normal heart]. 807 77

The author present a review of contemporary views on the pathogenesis of type I diabetes, in particular with regard to recent research of European and non-European diabetelogical departments. In the aetiopathogenesis attention is drawn to genetic influences, external factor and stimuli, the importance of some virus groups (Picornidae, Mengo 2T virus, Coxsackie B5, cytomegaloviruses, congenital rubeola syndrome etc.). Special attention is paid to the autoimmune theory of type I diabetes, the importance of different types of anti- beta-cell antibodies, insulin antibodies, antibodies against protein 64-KD of the islets, pro-insulin antibody PAA, and other stimuli and interferences (oxidation stress, non-enzymatic glycosylation etc.). As to treatment, the author mentions immunosuppressive treatment (cyclosporin A, azathioprine, prednisone) and transplantation of the pancreas. The author presents his own experience with a group of 2040 diabetics; in a group of 253 juvenile diabetics he followed-up the development of micro- and macroangiopathic complications in the course of 25 years. He proved an increase of so-called late diabetic complications in particular vascular ones along with the lengthening period of diabetes, with advancing age during its clinical manifestation. In the conclusion the author draws attention to the importance of multi-centre studies and new laboratory techniques.
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PMID:[New findings in type I diabetes]. 813 Nov 77

A nationwide mumps-measles-rubella vaccination was introduced in 1982 in Finland to children aged 1.5 to 6 years and since then mumps has virtually disappeared in the country. We investigated whether this rapid epidemiological change had any impact on antibody activity against mumps virus in Type 1 (insulin-dependent) diabetic children or on the incidence of Type 1 diabetes in Finland. Two case-control series were collected before (series I and II) and three series after (series III-V) the introduction of the vaccination. IgA class mumps antibody levels were significantly higher in Type 1 diabetic children than in matched control children in the first two but not in the three later series. IgG class antibody levels were similar in patients and control subjects in the first two series but significantly lower in patients than in control subjects in the three later series. The overall incidence of Type 1 diabetes in 0-14-year-old children increased until 1987 but remained about the same during 1988-1990. In 5-9-year-old children no further increase in Type 1 diabetes was seen since 1985, whereas in 0-4-year-old children the incidence continued to rise until 1990. The results suggest that the elimination of natural mumps by mumps-measles-rubella vaccination may have decreased the risk for Type 1 diabetes in Finland; a possible causal relationship is substantiated by the observed concomitant decrease in mumps antibody levels in diabetic children. However, further studies are required to determine if the vaccine virus, like natural mumps, could trigger the clinical onset of Type 1 diabetes in young children.
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PMID:Decline of mumps antibodies in type 1 (insulin-dependent) diabetic children and a plateau in the rising incidence of type 1 diabetes after introduction of the mumps-measles-rubella vaccine in Finland. Childhood Diabetes in Finland Study Group. 830 60

Genetic and immunological markers in children with Type I diabetes have not been studied previously in Venezuela. We evaluated 91 newly diagnosed IDDM children mean age 7.8 +/- 4.5 (range 0.8-20.8 years), 51 females and 40 males. Eleven percent of first degree relatives had a family history of Type I IDDM; 56.7% had had upper respiratory infection prior to diagnosis and 12.7% had had either mumps or varicella. Peak incidence of disease was found in February and March and August to October. Eighty seven percent had HLA-DR3 and/or DR4 vs 36% of the Venezuelan general population; 81.6% were HLA-DQW2 and/or HLA-DQW8. We found 55.9% to have positive islet cell antibodies (ICA) with 4 of these having a positive complement fixation test. Three patients (7.9%) were found to have positive insulin autoantibodies. Only 3 out of 11 HLA-identical siblings had positive ICAs, while none had positive insulin autoantibodies. One of them also had a positive complement fixation test; this subject developed IDDM. No positive serotypes for enterovirus (Coxsackie-B) were found in our patients, but we detected 11 cases with elevated titers for cytomegalovirus antibodies and positive antibodies for measles, mumps, herpes and varicella were found in some children. These data confirm that most of our Type I diabetics carry HLA-DR3 or DR4 and that the heterozygous DR3/DR4 phenotype is markedly increased in this population; they also indicate that DR3QW2 and DR4QW8 are associated with increased risk in our population.
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PMID:Epidemiology and inmunogenetics in recently diagnosed Venezuelan children with insulin-dependent diabetes mellitus. 839 77


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