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

We undertook this study to determine the incidence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) after gestational diabetes mellitus (GDM). It is a follow-up study of a consecutive sample of women with GDM in a tertiary care center in Trinidad, West Indies. The cohort was a consecutive sample of 157 women with GDM who delivered in the hospital between June 1981 and December 1984. Of these, a volunteer sample of 60 women (38%) consented to participate 3.5-6.5 yr later. The two groups were remarkably similar in ethnic composition, mean age at index delivery, marital status, and family history of DM. Interviews revealed that 26 women (43%) had already developed DM for which they were receiving treatment. The remaining 34 women (57%) were given a 2-h 75-g oral glucose tolerance test, and fasting and half-hourly venous blood samples were obtained and analyzed for plasma glucose. Based on accepted diagnostic criteria, 11 (32%) of 34 had DM, 10 (29%) had IGT, and 13 (38%) had normal glucose tolerance. A total of 37 (62%) of 60 women had developed DM, and another 10 (17%) had IGT in the intervening 3.5-6.5 yr. The results support findings that GDM is associated with an increased risk of mothers developing DM in later life.
Diabetes Care 1990 May
PMID:Occurrence of diabetes mellitus after gestational diabetes mellitus in Trinidad. 235 Oct 31

Thirty patients with gouty arthritis were studied over 3 years. The diagnosis was established with the help of polarised light microscopy. All the patients were males, with a median age of 45 years. They belonged to the middle or upper socio-economic class and were obese (mean body mass index 29.7). Chronic alcoholism, diabetes mellitus and hypertension were present in one patient each. No patient had symptomatic coronary artery disease. Although 6 patients had a history of renal colic, only one had gouty nephropathy with chronic renal failure. Six patients had a positive family history of gout. The disease involved mostly the joints of the lower extremity and podagra was observed in 70% of patients. Eight patients had tophi at various sites. There were 17 'over producers' and 13 'under excretors' of uric acid. The treatment consisted of patient education, symptomatic control with non steroidal anti-inflammatory drugs and/or colchicine and antihyperuricaemic therapy. The overproducers were treated with allopurinol while the under excretors were treated with [corrected] sulfinpyrazone. In general, there was a good response to therapy as indicated by lowering of serum uric acid and the number of painful episodes per year. The overall profile of the disease appears similar to that seen in the West.
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PMID:Clinical profile, therapeutic approach and outcome of gouty arthritis in northern India. 238 54

This article describes the surgery of tropical pancreatitis as practiced in a region of high incidence, based on the experience at 2 centers: the Department of Surgical Gastroenterology and Proctology, Government General Hospital, Madras, Tamilnadu (a tertiary-care referral unit) where 52 patients were diagnosed and 40 were operated on between 1982 and 1987; and the Department of Gastroenterology, Deva Matha Hospital, Koothattukulam (a specialized center located in the main endemic area of Kerala), where 116 patients were diagnosed and 33 operated on between 1983 and 1988. The latter series is described in detail with emphasis on the preoperative imaging, operative findings, surgical procedures, complications, and results of surgery. The experience of other centers in southern India is summarized and discussed. The disease is obviously different from chronic pancreatitis in the West. Special problems of tropical pancreatitis, particularly the management of diabetes and the association of pancreatic carcinoma at a young age, are discussed.
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PMID:Observations and surgical management of tropical pancreatitis in Kerala and southern India. 240 37

During the last two decades, islet cell transplantation has been pursed both experimentally and clinically in an effort to ameliorate diabetes mellitus. At present, however, islet cell transplantation still remains at the experimental stages as far as the treatment of diabetes is concerned. Also, culture of islet cells has proved to be rather frustrating and difficult. No consistent techniques have been developed, and simplified methods for islet cell preparation and adequate sites for islet cell placement would allow for further progress in this area. Ultimately, rejection remains the greatest obstacle to success. We report a simplified technique for enriching dog pancreatic islet cells. This preparation was injected into the renal subcapsular space in both homograft (3 experiments) and heterograft (3 experiments) situations. After six weeks, nephrectomy was performed, and histochemical techniques demonstrated many groups of live islets in between the tubules in the renal cortex. No acinar cells were observed. Blood samples from the renal artery and renal vein at the time of nephrectomy revealed an average 36.9% increase in insulin concentration in the renal veins, supporting an active secretory role of these transplanted islet cells. This technique points to (i) the possible role of "renal factor" in promoting growth of islet cells and (ii) the feasibility of successful transplantation of enriched islet cells as a potential approach to the curative treatment of diabetes mellitus.
West Indian Med J 1989 Jun
PMID:Renal subcapsular islet cell transplantation in the dog. A preliminary report. 250 40

A survey was carried out to determine the prevalence of known diabetes amongst West Indians living in Wolverhampton. Two hundred and fifty-one West Indians with diabetes were identified from a computerized register, which records all diabetic patients in the Wolverhampton area attending either the hospital diabetic clinic or general practitioner mini-clinics, and from questionnaire data obtained through local general practitioners. An estimated 4.4% of the Wolverhampton population are of West Indian origin determined by the 1981 census, giving a prevalence of known diabetes of 2.2% compared with 1.2% in the indigenous UK white Caucasian population. Only 4% of these patients were truly insulin-dependent but 38% were insulin-treated, 43% were on oral hypoglycaemic agents and 19% on diet alone. Only 1.6% were diagnosed below the age of 20 years, with peak frequency of diabetes occurring in the age group 45-64 years. Thirty-eight percent of all patients were obese, 40% were hypertensive, but only 4% had a history of angina or myocardial infarction. In UK West Indians non-insulin-dependent diabetes is common and is predominantly a disease of middle age, whereas insulin-dependent diabetes is relatively uncommon.
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PMID:Diabetes in the UK West indian community: the Wolverhampton survey. 252 74

Functional capacity and associated factors were studied in 321 men from eastern Finland and 395 men from southwestern Finland in connection with the 25-year follow-up survey of the East-West Study. The survey was carried out in autumn 1984, when the men were 65-84 years of age. In the measurement of different activities of daily living, 55 to 95% in the east and 62 to 97% in the south-west reported that they managed daily activities without another person's help. Both the mean age of the men and the mean of the sum index of functional capacity as stratified by age were in southwestern Finland significantly higher than in eastern Finland. Older age groups had lower functional capacity in both areas. Lowered functional capacity was associated with cardiovascular diseases, diabetes mellitus and impairments of vision in both areas, and with impairments of the locomotor system in the south-west. High pulmonary function was associated with high functional capacity. No connection was found between smoking and functional capacity, but heavier alcohol and coffee consumption were associated with high functional capacity.
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PMID:Functional capacity and associated factors in elderly Finnish men. 252 60

Data from the clinical records of patients known to have diabetes and admitted to hospital in North West London, Cambridge or Newcastle were compared with data on the same admissions taken from the system responsible for recording information on all acute hospital admissions (Hospital Activity Analysis). In 89 out of 751 admissions (12%), either the sex, date of birth or marital status of the patient was incorrectly recorded. The diagnosis of diabetes was omitted in 32 (10%) of 315 admissions in which diabetes or a complication of diabetes was regarded as the principal cause of admission and in 12 (23%) out of 53 in which the principal cause was closely related to diabetes. These included cases in which the diagnosis had not been stated (by the clinician) on the discharge summary (the source document for Hospital Activity Analysis) as well as instances in which the coding clerk had failed to record the diagnosis. The validity of information collected on hospital admissions is dependent on the presentation of data by the clinician to the coding clerk. There may be a lack of awareness of the importance of the clinical discharge summary as a source document for such systems.
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PMID:Validity of routinely collected hospital admissions data on diabetes. 252 36

Factors predicting disability in late life were studied in 716 men from eastern or southwestern Finland in connection with the 25-year follow-up of the East-West Study, which is part of the Seven Countries Study, in 1984. In middle-aged men, low forced vital capacity, occurrence of diabetes, presence of intermittent claudication, high diastolic blood pressure, higher age and lower educational level showed the greatest predicting power for future disability 15-25 years later. In later middle age, low forced vital capacity, presence of intermittent claudication, cerebrovascular disease or coronary heart disease and higher age were the most powerful predictors for disability 10 years later. In order to lower disability in old age, it is important to prevent deterioration of ventilatory function and cardiovascular diseases in middle-aged populations and to treat chronic diseases adequately.
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PMID:Predictors of disability in elderly Finnish men--a longitudinal study. 258 12

The purpose of this descriptive correlational study was to examine the relationships among health-promoting behaviors, perceived social support, and self-reported health of 113 persons age 55 years and over, who were attending nutrition sites in northern West Virginia. Three hypotheses were formulated: (1) health-promoting behaviors are positively related to perceived social support; (2) health-promoting behaviors are positively related to self-reported health, and (3) perceived social support is positively related to self-reported health. Only the first two were supported by our findings. Data analysis revealed positive correlations between the average health-promoting lifestyle profile (HPLP) score and education, and frequency of attending the nutrition site screening clinics for high blood pressure and diabetes. Better-educated subjects scored higher on selected subscales of the HPLP (self-actualization and health responsibility). Age was negatively correlated with the HPLP subscales of health responsibility and exercise. Nurses and support personnel at nutrition sites should focus increased attention on the older participants and those who are less well-educated. Expanding the variety and frequency of health services available to nutrition site participants merits attention.
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PMID:Health-promoting behaviors, perceived social support, and self-reported health of Appalachian elderly. 261 52

A ten-year community survey was undertaken to investigate the high coronary heart disease (CHD) incidence among people of Indian (South Asian) descent in Trinidad, West Indies. Of 2491 individuals aged 35-69 years, 2215 (89%) were examined and 2069 (83%) found to be clinically free of CHD at baseline. After exclusion of 71 of minority ethnic groups, 786 African, 598 Indian, 147 European and 467 adults of Mixed descent were followed for CHD morbidity and mortality. In both sexes, adults of Indian origin had higher prevalence rates of diabetes mellitus, a low concentration of high-density lipoprotein (HDL) cholesterol, and recent abstinence from alcohol than other ethnic groups. Indian men also had larger skinfold thicknesses than other men. In participants free of CHD at entry, the age-adjusted relative risk of a cardiac event believed due to CHD was at least twice as high in Indian men and women as in other ethnic groups. In men, blood pressure, diabetes mellitus and low-density lipoprotein (LDL) cholesterol concentration were positively and independently related to risk of CHD, whereas alcohol consumption and HDL cholesterol concentration were inversely associated with risk after allowing for age and ethnic group. The ethnic contrasts in CHD persisted when these characteristics were taken into account. In the smaller sample of women, only ethnic group was predictive of CHD as defined. The failure of point estimates of risk to explain the high CHD incidence in Indians calls for focus on age of onset of risk and examination of other potential risk factors such as insulin concentration.
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PMID:Ethnicity and other characteristics predictive of coronary heart disease in a developing community: principal results of the St James Survey, Trinidad. 262 Oct 16


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