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Biomedical subjects

B E Klein

Publications and source records attributed to B E Klein.

At least 253 records · Page 14Linked to original sources
PubMed1985

Blood pressure and hypertension in diabetes.

Blood pressure was measured in a population-based study of diabetic retinopathy in southern Wisconsin. Persons diagnosed prior to 30 years of age and taking insulin (younger onset, n = 996) and those diagnosed at 30 years of age or older (older onset, n = 1,370) were examined. Blood pressures were measured by a standard protocol using a random-zero sphygmomanometer. In both groups of patients, systolic blood pressure increased with increasing age and tended to be higher in older onset than younger onset persons. Hypertension was present in 21.9% of the younger and 58.1% of the older onset group. Older age at examination, presence of proteinuria, larger body mass, gender, and longer duration of diabetes were significantly associated with higher systolic blood pressure.

Adolescent↗
PubMed1984

The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years.

In a population-based study in southern Wisconsin, 996 insulin-taking, younger-onset diabetic persons were examined using standard protocols to determine the prevalence and severity of diabetic retinopathy and associated risk variables. The prevalence of diabetic retinopathy varied from 17% to 97.5% in persons with diabetes for less than five years and 15 or more years, respectively. Proliferative retinopathy varied from 1.2% to 67% in persons with diabetes for less than ten years and 35 or more years, respectively. For persons with diabetes of 10 years' duration or less, the Cox regression model relates the severity or retinopathy to longer duration, older age at examination, and higher levels of glycosylated hemoglobin. After ten years of diabetes, severity of retinopathy was related to longer duration, high levels of glycosylated hemoglobin, presence of proteinuria, higher diastolic BP, and male sex.

Adolescent↗
PubMed1984

The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years.

In a population-based study in southern Wisconsin, 1,370 patients given diagnoses of diabetes at age 30 years or older were examined using standard protocols to determine the prevalence and severity of diabetic retinopathy and associated risk variables. The prevalence of diabetic retinopathy varied from 28.8% in persons who had diabetes for less than five years to 77.8% in persons who had diabetes for 15 or more years. The rate of proliferative diabetic retinopathy varied from 2.0% in persons who had diabetes for less than five years to 15.5% in persons who had diabetes for 15 or more years. By using the Cox regression model, the severity of retinopathy was found to be related to longer duration of diabetes, younger age at diagnosis, higher glycosylated hemoglobin levels, higher systolic BP, use of insulin, presence of proteinuria, and small body mass.

Aged↗
PubMed1984

Hypoglycemic therapy in patients diagnosed to have diabetes at 30 years of age or older.

Treatment patterns were investigated for a population of diabetic persons diagnosed at 30 years of age or older who received primary medical care in an eleven county area in southern Wisconsin. Of the 6074 patients who met the diagnostic criteria for diabetes, 51% received their primary care from internists, 35% from general practitioners, and 14% from family practitioners. Insulin usage was more frequent in patients with a longer duration of diabetes, younger age at diagnosis and poor recent glucose control. Prescription of oral medications increased with increasing current age and age at diagnosis. A greater proportion of the patients of internists than those of general practitioners were treated with insulin. Oral hypoglycemic agents were prescribed more frequently for patients of general practitioners than for patients of internists. These differences remained after controlling for duration, age at diagnosis, and status of recent glucose control. Therefore, practitioner type is associated with treatment prescribed for diabetic patients diagnosed after 30 years of age.

Administration, Oral↗
PubMed1984

The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema.

The prevalence of macular edema and its relationship to a number of risk factors were examined in a population-based study in southern Wisconsin. Macular edema was determined from its presence on stereoscopic fundus photographs or from past history as recorded and documented in clinic records and photographs. For participants whose age at diagnosis of diabetes was less than 30 years and who were taking insulin (n = 919), prevalence rates of macular edema varied from 0% in those who had diabetes less than 5 years to 29% in those whose duration of diabetes was 20 or more years. In these persons, macular edema was associated with longer duration of diabetes, presence of proteinuria, diuretic use, male gender and higher glycosylated hemoglobin. For those whose age at diagnosis was 30 years or older (n = 1121), prevalence rates of macular edema varied from 3% in those who had diabetes less than 5 years to 28% in those whose duration of diabetes was 20 or more years. In these persons, presence of macular edema was associated with longer duration of diabetes, higher systolic blood pressure, insulin use, higher glycosylated hemoglobin, and presence of proteinuria.

Adolescent↗
PubMed1984

Intraocular pressure in diabetic persons.

Intraocular pressure measurements were taken in 2366 diabetic persons and 381 nondiabetic persons who lived in southern Wisconsin. Diabetic persons tended to have higher mean intraocular pressure than the nondiabetic persons. Higher blood pressure, earlier time of day of IOP measurement, absence of cataract and, in some comparisons, female gender, were significantly associated with higher intraocular pressure. In this study rates of a positive history of glaucoma were higher in diabetic persons than in nondiabetic persons and the population participating in the Health Interview Survey. These findings suggest that ophthalmologists must be aware of the increased risk of glaucoma when evaluating diabetic patients.

Adolescent↗
PubMed1984

Diabetic retinopathy. Assessment of severity and progression.

This study describes a classification of overall retinopathy severity based on the presence and severity of lesions graded in the Airlie House classification of diabetic retinopathy, and demonstrates its use in assessing progression of retinopathy over a 6-year period in a group of insulin-taking patients. One hundred and ninety-one insulin-taking patients with diabetes of at least 5 years' duration were identified from their doctors' records in 1970-1971. Patients were seen again in 1972-1973 and 1976-1977. Stereoscopic color fundus photographs of 7 fields in each eye were taken at each visit. All photos were graded using a modification of the Airlie House classification, which specified 6 levels of retinopathy for a given eye; when both eyes are considered an 11-step grading scheme results. Of all patients seen at the 2-year visit whose retinopathy was at risk of progressing, 41.2% showed progression of one level or more on the scale, 19.2% progression of two or more levels. At the 6-year examination comparable rates were 75.0% and 58.4%. Of patients whose retinopathy was level 4 in each eye (nonproliferative retinopathy of "moderate" severity) at the baseline visit, 13/21 (72%) had progressed to proliferative retinopathy in at least one eye at the 6-year examination. The classification scheme proposed appears useful for characterizing overall retinopathy severity of patients on the basis of gradings of fundus photographs. The data presented may be of help in planning trials of treatment aimed at slowing the development or progression of retinopathy.

Adolescent↗
PubMed1984

Prevalence of diabetes mellitus in southern Wisconsin.

The prevalence of known cases of diabetes was ascertained from patient records in an 11-county area in Wisconsin in July 1979 to June 1980. The prevalence in the noninstitutionalized population was found to be 1%. Prevalence rates rose from 0.5 cases per 1000 population in the first decade of life to 44.7 cases per 1000 population in the eighth decade. The highest rates were found in the nursing home population. Males had higher age-adjusted rates than females. No difference in prevalence was found between persons living in metropolitan or nonmetropolitan counties. Determination of prevalence by these methods is a rapid and inexpensive means of ascertainment of known cases of diabetes.

Adolescent↗
PubMed1984

Gravidity and diabetic retinopathy.

The relationship between gravidity and severity of diabetic retinopathy was investigated in a population-based sample of diabetic patients. All of these women had had diabetes diagnosed before 30 years of age and were taking insulin. All received their primary medical care in an 11-county region of southwestern Wisconsin (Health Service Area 1). Each participant had an ophthalmologic examination which included stereoscopic fundus photography of seven standard fields in each eye. Photos were graded according to a standard protocol. Of the 397 women, 197 had never been pregnant, 88 had been pregnant once, 56 had been pregnant twice, and 56 had been pregnant three or more times after diabetes was diagnosed. The number of pregnancies was positively associated with the severity of retinopathy. However, after controlling for duration of diabetes, this relationship was no longer apparent. Using an ordinal regression model, duration of diabetes, diastolic blood pressure and glycosylated hemoglobin were significant predictors of the severity of diabetic retinopathy.

Adult↗
PubMed1984

Blood pressure in a population of diabetic persons diagnosed after 30 years of age.

Blood pressure levels were investigated in a population of diabetic persons who were diagnosed at 30 years of age or older and who received their primary medical care in an 11-county area in Southern Wisconsin. Prevalence of hypertension in these 5,104 persons was compared with prevalence figures from the Health and Nutrition Examination Survey (HANES) population. Diabetic women had a higher prevalence of hypertension until 65 years of age than did women of similar ages in the HANES. The diabetic males had a prevalence of hypertension similar to that of male HANES participants. Mean systolic blood pressures tended to be slightly higher in persons with "poorest" level of glucose control compared to those whose blood glucose was "best" controlled. Persons for whom diuretic agents had been prescribed were as likely to have blood glucose values in the "poorest" levels of control as persons not using diuretics.

Adult↗
PubMed1984

Visual impairment in diabetes.

Visual acuity was measured in a population-based study of diabetic retinopathy in southern Wisconsin. Persons diagnosed prior to 30 years of age and taking insulin (younger onset, n = 996) and those diagnosed at 30 years of age or older (older onset, n = 1370) were examined. Best corrected visual acuity was determined using the Early Treatment of Diabetic Retinopathy Study protocol. In the younger onset group, 1.4% had moderate visual impairment (best corrected visual acuity in the better eye of 20/80 to 20/160) and 3.6% were legally blind (visual acuity in the better eye of 20/200 or worse). Visual impairment in this group was associated with older age at examination, longer duration of diabetes, presence of proliferative retinopathy, and presence of senile cataracts. In the older onset group, 3.0% had moderate visual impairment and 1.6% were legally blind. Visual impairment in this group was associated with older age at examination, longer duration of diabetes, presence of senile cataract, presence of macular edema, and proliferative diabetic retinopathy. When assigning causes of impaired vision, diabetic retinopathy was responsible in part for 86% of eyes with visual acuity of 20/200 or worse in younger onset persons and for 33% in older onset persons.

Adult↗
PubMed1983

Inter-observer variation in refraction and visual acuity measurement using a standardized protocol.

Reproducible measures of refraction and visual acuity are necessary in clinical and population studies of eye diseases. Inter-observer differences in measurements of these parameters were evaluated using the Early Treatment of Diabetic Retinopathy Study (ETDRS) protocol. No clinically significant interobserver variation was found for refraction or visual acuity measurements between three observers. This study confirms that when standardized measurement procedures are used, observer differences as a source of variability in the data can be minimized.

Evaluation Studies as Topic↗
PubMed1983

Is cigarette smoking associated with diabetic retinopathy?

The relationship between cigarette smoking and diabetic retinopathy is examined in this report. All participants were examined between September 1980 and July 1981 as part of a population-based study in southwestern Wisconsin. Exposure data on cigarette smoking at the time of examination were derived from a set of questions about present or past smoking history, duration of smoking, and number of cigarettes smoked per day. Retinopathy status was determined according to the modified Airlie House classification. The rate of diabetic retinopathy varied from 21% in those who had diabetes for 0-4.9 years to 97% in those who had diabetes for 15 or more years, for persons diagnosed before 30 years of age, and from 28% to 78% for comparable durations in those diagnosed at 30 years or older. There was no association between smoking history and duration of diabetes. In participants diagnosed before age 30, the relative risk for the presence of retinopathy in smokers compared with those who had never smoked was 1.06 (95% confidence limits (CL) 0.97-1.18); in participants diagnosed at 30 years or older it was 0.89 (95% CL 0.75-1.06). There was no relationship between the risk or severity of retinopathy and number of cigarettes smoked daily, or the number of pack-years smoked while diabetic. These data suggest that there is no excess risk of retinopathy in smokers or ex-smokers when contrasted with those who never smoked.

Adolescent↗
PubMed1982

Cataracts and macular degeneration in older Americans.

Cataracts and macular degeneration compromise visual function in older persons. In the Health and Nutrition Examination Survey, the incidence of cataracts for persons aged 45 to 64 years was as follows: white men, 5.6%; white women, 2.1%; black men, 8.3%; and black women, 8.5%. For persons aged 65 to 75 years, the rates were as follows: white men, 21.6%; white women, 26.8%; black men, 38.3%; and black women, 39.1%. For macular degeneration the rates in persons aged 45 to 64 years were as follows: white men, 2.3%; white women, 2.3%; black men, 3.8%; and black women, 2.4%. For the older age group, the rates were as follows: white men, 9.6%; white women, 6.9%; black men, 9.3%; and black women, 11.4%. Mean systolic blood pressure tended to be slightly higher in persons with either cataracts or macular degeneration than in persons without these conditions.

Adolescent↗
PubMed1981

Intraocular pressure and cardiovascular risk variables.

The relationship between intraocular pressure and several cardiovascular risk factors was evaluated in data from the Health and Nutrition Examination Survey of 1971 to 1974. Mean IOP increased with increasing age for all groups. Blacks tended to have slightly higher levels than did whites. Intraocular pressure was correlated positively with systemic blood pressure in all groups. The pattern of the association of IOP with hematocrit reading, sedimentation rate, pulse rate, and serum cholesterol level was not consistent in the four race-sex groups. In all groups the variables in a regression model accounted for, at most, 8% of the variability in IOP reading.

Adolescent↗
PubMed1979

Thymidine kinase and DNA polymerase activity during postnatal growth of the epididymal fat pad.

Thymidine kinase and DNA polymerase enzyme activities were measured in epididymal adipose tissue from rats of 12 to 182 days of age. Both enzymes showed highest specific activity during the suckling period; by 35 days of age both thymidine kinase and DNA polymerase enzyme activities had decreased to stable lower levels. The activities of the two proliferative enzymes resembled the pattern of [3H]thymidine incorporation into preadipocytes shown by Greenwood and Hirsch (1) and the data support the concept that a pool of preadipocytes develops during the first 4 to 5 weeks postnatally. Further, the thymidine kinase and DNA polymerase enzyme activities were correlated with the rate of DNA accretion in the preadipocyte fraction of the tissue. Since thymidine kinase activity can be measured in 20 to 40 mg of tissue. Since thymidine kinase activity can be measured in 20 to 40 mg of tissue, the technique can be adapted for measurement of enzyme levels in human or animal biopsy samples when radio-isotope studies are not advisable or only small quantities of tissue are available.

Adipose Tissue↗