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 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A pathogenic relationship exists between type 2 diabetes and obesity. Over the last decade, the escalation in diabetes cases has paralleled the rapid increase in obesity rates, constituting a global health crisis. Environmental risk factors attributed to the global increase in obesity include the consumption of high-calorie, high-fat foods and inadequate physical activity. Obese individuals may also have a genetic predisposition for obesity. Both diabetes and obesity confer an elevated risk of developing a range of complications and comorbidities, including cardiovascular disease, hypertension and stroke, which can complicate disease management. This review examines the aetiology of the linkages between diabetes and obesity and the range of available therapies. Recent clinical evidence substantiating the efficacy and safety of incretin-based antidiabetic therapies is analysed, in addition to data on antiobesity therapeutic strategies, such as antiobesity agents, behaviour modification and bariatric surgery. Glucose control is often accompanied by weight-neutral or modest weight reduction effects with DPP-4 inhibitor treatment (sitagliptin, vildagliptin, saxagliptin) and weight loss with GLP-1 receptor agonist therapy (exenatide, liraglutide). Studies of antiobesity agents including orlistat, sibutramine and rimonabant have shown attrition rates of 30-40%, and the long-term effects of these agents remain unknown. Bariatric surgical procedures commonly performed are laparoscopic adjustable banding of the stomach and the Roux-en-Y gastric bypass, and have produced type 2 diabetes remission rates of up to 73%. Therapeutic strategies that integrate glycaemic control and weight loss will assume greater importance as the prevalence of diabetes and obesity increase.
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PMID:Diabesity: therapeutic options. 2051 2

This paper discusses the result of a mortality analysis carried out in the Federated States of Micronesia in 2005. The result shows that the population crude mortality rate decreased slightly between the years 1990-1992. Disease-specific mortality was highest among the chronic, or non-communicable diseases (i.e., diabetes, stroke, cancer, heart disease combined) compared to communicable diseases and injury combined. In addition, the study suggests that mortality due to NCD is occurring among people as young as 40 years old. In order to curb this trend, the authors recommend drastic change to the current health care delivery system.
Pac Health Dialog 2010 Apr
PMID:Mortality analysis of registered deaths in the FSM from 1990-2003. 2096 43

Determining biological network dependencies that can help predict the behavior of a system given prior observations from high-throughput data is a very valuable but difficult task, especially in the light of the ever-increasing volume of experimental data. Such an endeavor can be greatly enhanced by considering regulatory influences on co-expressed groups of genes representing functional modules, thus constraining the number of parameters in the system. This allows development of network models that are predictive of system dynamics. We first develop a predictive network model of the transcriptomics of whole blood from a mouse model of neuroprotection in ischemic stroke, and show that it can accurately predict system behavior under novel conditions. We then use a network topology approach to expand the set of regulators considered and show that addition of topological bottlenecks improves the performance of the predictive model. Finally, we explore how improvements in definition of functional modules may be achieved through an integration of inferred network relationships and functional relationships defined using Gene Ontology similarity. We show that appropriate integration of these two types of relationships can result in models with improved performance.
Pac Symp Biocomput 2011
PMID:Defining the players in higher-order networks: predictive modeling for reverse engineering functional influence networks. 2112 Oct 59

Currently available drugs for the acute treatment of migraine, i.e. ergot alkaloids and triptans, are cranial vasoconstrictors. Although cranial vasoconstriction is likely to mediate-at least a part of-their therapeutic effects, this property also causes vascular side-effects. Indeed, the ergot alkaloids and the triptans have been reported to induce myocardial ischemia and stroke, albeit in extremely rare cases, and are contraindicated in patients with known cardiovascular risk factors. In view of these limitations, novel antimigraine drugs devoid of vascular (side) effects are being explored. Currently, calcitonin gene-related peptide (CGRP) receptor antagonists, which do not have direct vasoconstrictor effects, are under clinical development. Other classes of drugs, such as 5-HT(1F) receptor agonists, glutamate receptor antagonists, nitric oxide synthase inhibitors, VPAC/PAC receptor antagonists and gap junction modulators, have also been proposed as potential targets for acute antimigraine drugs. Although these prospective drugs do not directly induce vasoconstriction, they may well induce indirect vascular effects by inhibiting or otherwise modulating the responses to endogenous vasoactive substances. These indirect vascular effects might contribute to the therapeutic efficacy of the previously mentioned compounds, but may alternatively also lead to vascular side-effects. As described in the current review, some of the prospective antimigraine drugs with a proposed non-vascular mechanism of action may still have direct or indirect vascular effects.
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PMID:Potential mechanisms of prospective antimigraine drugs: a focus on vascular (side) effects. 2113 Aug 7

Most regions of Australia are exposed to hot summers and regular extreme heat events; and numerous studies have associated high ambient temperatures with adverse health outcomes in Australian cities. Extreme environmental heat can trigger the onset of acute conditions, including heat stroke and dehydration, as well as exacerbate a range of underlying illnesses. Consequently, in the absence of adaptation, the associated mortality and morbidity are expected to increase in a warming climate, particularly within the vulnerable populations of the elderly, children, those with chronic diseases, and people engaged in physical labour in noncooled environments. There is a need for further research to address the evidence needs of public health agencies in Australia. Building resilience to extreme heat events, especially for the most vulnerable groups, is a priority. Public health professionals and executives need to be aware of the very real and urgent need to act now.
Asia Pac J Public Health 2011 Mar
PMID:The effects of extreme heat on human mortality and morbidity in Australia: implications for public health. 2176 35

International mortality studies show that some subgroups of migrants have a higher risk of Cardiovascular Disease (CVD) than the native-born. To investigate whether country of birth increases the risk for acute myocardial infarction (AMI) and cerebral infarction (stroke) hospitalization in Victoria, Australia. A retrospective analysis of Victorian AMI (ICD-10-AM codes I21 and I22) and stroke (ICD-10-AM I63 and I64) discharges from routinely collected hospital data in 2001-2002 was conducted. The outcome measures were directly age standardized rate ratios (RRs) of AMI and stroke hospitalization, calculated using 2001 Australian census data, with the Australian-born as the reference group. Males from 4 ethnic groups--USSR/Baltic; Southern Asia; Middle East; and Eastern Europe, displayed higher risk for AMI hospitalization than Australian-born men, whereas males and females from Southeast Asia and Northeast Asia were at lower risk. Furthermore, males from Western Europe and females from the Pacific were also at lower risk. Females from the Middle East, Southern Asia, and Southern Europe were at higher risk of stroke hospitalization than Australian-born women; in contrast, males from Eastern Europe, NorthAsia, Southern Asia, Southern Europe, and the United Kingdom and Ireland were at lower risk. Risk for AMI and stroke hospitalization varies by country of birth in comparison with the Australian-born population. It will be import to identify the factors associated with these varying risks in order to target preventive strategies aimed at reducing risk of AMI and stroke.
Asia Pac J Public Health 2011 May
PMID:Is country of birth a risk factor for acute hospitalization for cardiovascular disease in Victoria, Australia? 2149 Jan 9

The purpose of this study was to examine the risks of the incidence of chronic conditions and life events on successful aging. Longitudinal data from a 10-year follow-up health survey were used. Successful aging indicators included basic and advanced physical function, depressive symptoms, cognitive function, emotional support, participation in productive activities, and life satisfaction. The stressors included life events and morbidity years of 10 chronic conditions. Loss of offspring increased the risk to physical health, psychological health, and life satisfaction. Being newly widowed was related to depressive symptoms, whereas being newly divorced increased the risk of poor social support. Morbidity years increased the risk of failure in successful aging, especially for stroke, respiratory system disease, diabetes, and cancer. Emotional health of the elderly should be carefully monitored after onset of life events and incidences of chronic conditions.
Asia Pac J Public Health 2011 Jul
PMID:Impact of morbidity and life events on successful aging. 2172 83

Migration to industrialised countries poses a "double whammy" for type 2 diabetes among sub-Saharan African migrant and refugee adults. This population group has been found to be at an increased risk of obesity and type 2 diabetes, which may be further aggravated by inadequate vitamin D status. Thus, this study aimed to describe the demographics of vitamin D insufficiency, obesity, and risk factors for type 2 diabetes among sub-Saharan African migrants and refugees aged 20 years or older living in Melbourne, Australia (n=49). Data were obtained by a questionnaire, medical assessment, and fasting blood samples. The mean serum 25-hydroxyvitamin D level was 27.3 nmol/L (95% CI: 22.2, 32.4 nmol/L); with 25-hydroxyvitamin D levels <50 nmol/L occurring in 88% of participants. Participants displayed a cluster of risk factors for type 2 diabetes and cardiovascular disease: 62% were overweight or obese, 47% had insulin resistance (HOMA-IR >=2), 25% had low density lipoprotein cholesterol levels >=3.5 mmol/L, 24.5% had high density lipoprotein cholesterol levels <=1.03 mmol/L, 34.6% had borderline or high levels of total cholesterol (>=5.2 mmol/L), 18.2% had borderline or high levels of triglyceride (>=1.7 mmol/L), and 16% had hypertension (systolic blood pressure >=140 mmHg or diastolic blood pressure >=90 mmHg). These findings suggest that sub-Saharan African migrants and refugees may be at risk of type 2 diabetes and atherosclerosis-related diseases such as ischemic heart disease, stroke, and peripheral vascular disease. Well-designed vitamin D interventions that incorporate lifestyle changes are urgently needed in this sub-population.
Asia Pac J Clin Nutr 2011
PMID:Prevalence of vitamin D insufficiency and risk factors for type 2 diabetes and cardiovascular disease among African migrant and refugee adults in Melbourne: a pilot study. 2185 58

The aim of the study was to investigate the risk of death for 12 months follow-up after registration of tuberculosis (TB), using a nationwide population-based retrospective cohort study. A total of 33851 new TB cases were enrolled from 2006 to 2008. Of these, 5584 (16.5%) patients died during the follow-up period because of TB, and 4224 (12.5%) patients died because of other causes. Multivariate survival analysis revealed that age, HIV, chronic kidney disease, stroke, cancer, and chronic liver disease and cirrhosis were significant risk factors associated with death. Patients of age 0 to 64 years with HIV, chronic kidney disease, cancer, stroke, chronic liver disease and cirrhosis, or diabetes had a higher risk of death than those without these comorbidities. The majority of the TB patients in Taiwan died because of causes other than TB, and death often occurred in the first 2 months after TB registration. Therefore, medical care and case management for those with comorbidities are advised to prevent death during TB treatment.
Asia Pac J Public Health 2015 Mar
PMID:Risk factors associated with death in a 12-month cohort analysis of tuberculosis patients: 12-month follow-up after registration. 2219 54

Data on factors affecting stroke recurrence are relatively limited. The authors examined potential factors affecting stroke recurrence, retrospectively. The study participants were 1087 patients who were admitted to stroke centers suffering from first-ever ischemic stroke and returned questionnaires with usable information after discharge. The authors analyzed the association between clinical parameters of the patients and their prognosis. Recurrence rate of during an average of 2 years after discharge was 21.3%, and there were differences among stroke subtypes. It was found that the disability level of the patients after discharge correlated well with the level at discharge (r s = 0.66). Multivariate logistic regression analysis of the data shows that modified Rankin Scale score, National Institute of Health Stroke Scale score, gender, age, and family history had statistically significant impacts on stroke recurrence, and the impact was different depending on subtypes. These findings suggest that aggressive and persistent health education for poststroke patients and management of risk factors are essential to reduce stroke recurrence.
Asia Pac J Public Health 2015 Mar
PMID:Multifactorial analysis of factors affecting recurrence of stroke in Japan. 2250 31


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