Biomedical subjects

B E Klein

Publications and source records attributed to B E Klein.

282 records · Page 16Linked to original sources

PubMedDate not supplied

An anatomic index for the severity of ocular injuries.

Ocular injuries are a frequent cause of monocular blindness and cause disfigurement and discomfort. We developed a measure of severity for eye injuries using a multi-attribute utility (MAU) model. The severity index scoring was applied to eye injuries that presented at hospitals in Wisconsin, U.S.A. The resulting distribution of severities was compatible with that seen by general eye care physicians. A severity scale provides a means of comparing the severity of injuries from a wide variety of traumatic sources (e.g. automobile crashes, combat injuries, occupational accidents, etc.) and is useful in evaluating preventive and public health measurements.

Eye↗

PubMedDate not supplied

Lp(a) is not related to retinopathy in diabetic subjects.

PURPOSE: To examine the association between Lp(a) concentrations and the severity of retinopathy in 22 younger-onset and 48 older-onset diabetic subjects from the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), a population-based study of diabetic retinopathy. METHODS: We used a subset of the WESDR population with standardized protocols and stereoscopic color fundus photography to determine the severity of diabetic retinopathy in relation to Lp(a) concentrations. Lp(a) concentrations were measured by a monoclonal anti-Lp(a) antibody. RESULTS: Lp(a) levels were not significantly different between younger-onset or older-onset subjects with and without retinopathy. CONCLUSION: Our results do not support a link between higher levels of Lp(a) and severe retinopathy in either younger-onset or older-onset diabetic subjects but this needs confirmation in larger prospective studies.

Adult↗

PubMedDate not supplied

Longitudinal measure of glycemic control and diabetic retinopathy.

In a population-based study, 5431 diabetic people in southern Wisconsin who were mature at onset of diabetes were identified, and their charts were reviewed. Recent glycemic control was evaluated from these charts. An index of recent glucose control with at least three glucose determinations abstracted from the doctor's chart was constructed. A sample of 1370 of the 5431 individuals was examined as part of this study. An index of glucose control could be derived for 568 of 674 people using insulin and for 565 of 696 nonusers of insulin. Correlation of the index with the glycosylated hemoglobin obtained at the time of study was significant in insulin users and nonusers. Patients with the poorest blood glucose control as described by index of past control or by current glycosylated hemoglobin had higher rates of retinopathy compared with patients who had the best control. When both the index of past control and current glycosylated hemoglobin values were combined, rate ratios for retinopathy for people with poorest control compared with those with best control were slightly better than when each measure was used alone. These analyses suggest that in planning programs, health-care impact may be increased if past and current data are considered.

Aged↗

PubMedDate not supplied

Is aspirin use associated with lower rates of cataracts in diabetic individuals?

The relationship between a history of aspirin use and cataracts in diabetic individuals is examined in this report from a population-based study of 1370 individuals who developed diabetes after 30 yr of age. After pupil dilation lenses were examined for the presence and severity of nuclear sclerotic and posterior subcapsular cataracts and for surgical aphakia. A history of aspirin usage was obtained. Seven hundred eighty-four individuals had used aspirin in the month before the exam. There was no relationship between such usage and cataracts. For 338 people who reported using aspirin daily for at least 3 mo while having diabetes, there was also no association. These data suggest that aspirin usage as measured here has little effect on the prevalence of cataract in older-onset diabetic patients.

Adult↗

PubMedDate not supplied

Is aspirin usage associated with diabetic retinopathy?

The relationship between the history of aspirin usage and diabetic retinopathy is examined in this report. The study population consists of a sample of people (n = 1370) who developed diabetes mellitus after 30 yr of age, who lived in south-central Wisconsin, and who participated in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. These participants were questioned about recent and past use of aspirin. There was no association between the number of aspirin used in the month before the exam and the severity of diabetic retinopathy. Three hundred thirty-eight of these individuals reported taking aspirin daily for at least 3 mo since they were diagnosed as having diabetes. There was no association between the severity of retinopathy and having used aspirin in this way. These analyses suggest that aspirin usage, as herein described, is unrelated to the severity of diabetic retinopathy in older-onset diabetic patients.

Aspirin↗

PubMedDate not supplied

New management concepts for timely diagnosis of diabetic retinopathy treatable by photocoagulation.

Diabetic retinopathy is a leading cause of blindness in the United States. Photocoagulation has been shown to reduce visual loss from macular edema and proliferative retinopathy. Because serious diabetic retinopathy may be asymptomatic and its detection difficult, several recommendations have been made by the National Diabetes Advisory Board for routine ophthalmologic examinations to ensure timely treatment. In geographic areas devoid of ophthalmologists, alternate approaches are necessary. These include intensive training of primary-care physicians in ophthalmoscopy, use of objective recording of retinopathy by fundus photography with interpretation of fundus photographs by retinal specialists, and better communication between primary-care physicians and retinal specialists.

Blindness↗

PubMedDate not supplied

A population-based study of diabetic retinopathy in insulin-using patients diagnosed before 30 years of age.

In a population-based study of the prevalence and severity of diabetic retinopathy in southern Wisconsin, 1210 insulin-taking persons who were diagnosed to have diabetes before 30 yr of age and who were receiving primary medical care in the area were identified in 1979-80. From 1980 to 1982, 996 patients were examined. Fundus photographs revealed that 72% of diabetic women and 69% of diabetic men had retinopathy. More men (12%) than women (7%) had severe proliferative retinopathy. Longer duration of diabetes, higher glycosylated hemoglobin, older age at examination, higher diastolic blood pressure, male gender, and presence of proteinuria all contributed significantly to describing increasing severity of retinopathy.

Age Factors↗

PubMedDate not supplied

Retinopathy in young-onset diabetic patients.

The relative importance of duration of diabetes before and after 13 yr of age as a risk factor for retinopathy was investigated using data from 200 persons who were younger than 26 yr of age. These persons were identified in a population-based study of diabetic retinopathy in southern Wisconsin in 1980-1982. Retinopathy was found in 9% of persons who were younger than 13 yr and in 34% of persons who were 13 yr or older and had been diagnosed at or after 13 yr. Presence of retinopathy was more strongly associated with the duration of diabetes after 13 yr of age than before it.

Adolescent↗

PubMedDate not supplied

Accuracy of self-reported hearing loss.

The purpose of this study was to assess the accuracy, in older adults, of questions assessing hearing loss. Study participants (n=3,556), aged 48-92 years, were examined in a population-based study of age-related hearing loss in Beaver Dam, Wisconsin. Self-report data from the ten-question Hearing Handicap Inventory for the Elderly-screening Version (HHIE-S), and four additional questions were compared with hearing loss as measured by pure-tone air conduction audiometry. The single question, 'Do you feel you have a hearing loss?' was the most sensitive question (sensitivity=71 per cent); its overall and gender-specific prevalence estimates were within 3.2 per cent of prevalence measures derived audiometrically, although age-group specific estimates were not as accurate. Using an HHIE-S total score >8 resulted in low sensitivity (34 per cent) and inaccurate prevalence estimates. These results indicate that, for some applications, one simple question may be sufficient for prevalence surveys of hearing loss among older adults.

Adult↗

PubMedDate not supplied

Association of leisure-time noise exposure and hearing loss.

The purpose of this study was to investigate the association of noisy leisure activities with hearing loss. Participants (n=3571) were examined in a population-based study of age-related hearing loss conducted in Beaver Dam, Wisconsin. Hearing thresholds were determined by audiometry. Hearing loss was defined as the pure-tone average of the frequencies 500, 1,000, 2,000, and 4,000 Hz greater than 25 dB HL in either ear. Information regarding exposure to leisure-time noise was obtained by interview. After adjusting for potential confounders, individuals who engaged in leisure activities with average sound levels greater than 90 dBA were significantly more likely to have a hearing loss than participants who did not engage in noisy leisure activities (OR=1.11, 95 per cent CI=1.01-1.22). Individuals who engaged in woodworking were 30 per cent more likely to have a hearing loss than those who had never done woodworking. There was a 6 per cent increased risk of hearing loss for each 5-year period of participation. Health care professionals should consider counseling their patients who engage in noisy leisure activities about the risk of noise-induced hearing loss.

Aged↗

PubMedDate not supplied

Cigarette smoking and lens opacities: the Beaver Dam Eye Study.

We evaluated the relationship between cigarette smoking behavior and lens opacities in cross-sectional data on 4,926 adults in Beaver Dam, Wisconsin. The frequencies of more severe levels of nuclear sclerosis increased with packyears of cigarette smoking in women and men. For women, the odds ratio (OR) associated with 10 packyears was 1.09 (confidence interval [CI] = 1.04, 1.16) and for men it was 1.09 (CI = 1.05, 1.14) after controlling for age. The frequencies of posterior subcapsular opacities also increased in both sexes with increased packyears. The OR associated with 10 packyears of cigarette smoking was 1.06 (CI = 0.98, 1.14) for women and 1.05 (CI = 1.00, 1.11) for men after controlling for age. There was no significant effect on cortical opacities. Smoking was associated with past cataract surgery. The significant relationships of smoking with lens opacities suggest an etiologic effect. If confirmed prospectively, our results would indicate another benefit of smoking cessation.

Adult↗

PubMedDate not supplied

Treatment and control of hypercholesterolemia and hypertension in persons with and without diabetes.

Our object was to examine whether the frequency of medical treatment for hypercholesterolemia or hypertension and the frequency of control of these conditions were different in persons with and without known diabetes. Subjects 43-86 years of age with (n = 376) and without (n = 4,420) known diabetes participated in the Beaver Dam Eye Study. Hypercholesterolemia was defined as a serum cholesterol of > or = 6.2 mmol/L or use of lipid-lowering agents, and hypertension was defined as a systolic blood pressure > or = 140 mm Hg or diastolic blood pressure > or = 90 mm Hg or use of antihypertensive medications. Those subjects with diabetes had a similar frequency of hypercholesterolemia (42.8% versus 43.3%, P = .22) and a significantly higher frequency of hypertension (73.1% versus 48.3%, P < .0001) than those without diabetes. In those who were hypercholesterolemic, subjects with diabetes were slightly more likely to use lipid-lowering agents than those without diabetes (14.6% versus 9.8%, P = .05). In those who were hypertensive, subjects with diabetes were more likely to be on antihypertensive medications than those without diabetes (77.4% versus 57.0%, P < .0001). After adjusting for sociodemographic and cardiovascular disease risk factors, the odds of a participant with hypercholesterolemia receiving treatment with lipid-lowering agents was 1.61 (95% confidence intervals [CI] = 0.98, 2.65) and the odds of a participant with hypertension receiving treatment with antihypertensive medications was 2.32 (95% CI = 1.68, 3.20) for those with diabetes versus those without.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗