Search PubMed⌕ Search

Biomedical subjects

H King

Publications and source records attributed to H King.

At least 55 records · Page 3Linked to original sources
PubMed1993

Glucose intolerance in Colombia. A population-based survey in an urban community.

OBJECTIVE: To determine the prevalence of diabetes and its relationship to age and obesity in an urban community in Colombia. RESEARCH DESIGN AND METHODS: A cluster sample of 670 adults > or = 30 yr of age was selected from the city of Santafé de Bogotá. Classification of diabetes and IGT was according to WHO criteria. RESULTS: Response to the survey, conducted in 1988-1989, was 71% for men and 84% for women. Prevalence of diabetes was 7% in both sexes. Prevalence of IGT was 5% in men and 7% in women. Age-standardized prevalence of diabetes in the 30- to 64-yr age range was comparable with that reported in urban Brazilians and rural Hispanics in the U.S.. Prevalence was higher than in the white population of the U.S. but lower than in several urban U.S. Hispanic communities. Some 40% of men and 30% of women with diabetes were unaware of their condition before the survey, but all those < 50 yr of age were diagnosed previously. Glucose intolerance was associated with high BMI in men and with advancing age in both sexes. CONCLUSIONS: Glucose intolerance is common in this community and will likely increase in frequency in Colombians with further urbanization and population aging.

Adult↗
PubMed1993

Diabetes in adults is now a Third World problem. World Health Organization Ad Hoc Diabetes Reporting Group.

Since 1988, the World Health Organization has been collecting standardized information on the prevalence of diabetes mellitus and impaired glucose tolerance in adult communities worldwide. Within the age range 30 to 64 years, diabetes and impaired glucose tolerance were found to be absent or rare in some traditional communities in Melanesia, East Africa, and South America. In communities of European origin, the prevalences of diabetes and impaired glucose tolerance were in the range of 3% to 10% and 3% to 15%, respectively, but migrant Indian, Chinese, and Hispanic American groups were at higher risk (15% to 20%). The highest risk was found among the Pima Indians of Arizona and the urbanized Micronesians of Nauru, where up to half of the population aged 30 to 64 years had diabetes. The prevalence of total glucose intolerance (diabetes and impaired glucose tolerance combined) was greater than 10% in almost all populations, and was within the 11% to 20% range for European and US white populations. However, the prevalence of total glucose intolerance reached almost 30% in Arab Omanis and US blacks and affected one third of all adult Chinese Mauritians, migrant Indians, urban Micronesians, and lower-income urban US Hispanics. In Nauruans and Pima Indians, approximately two thirds of all adults aged 30 to 64 years were affected. These results lead to three important conclusions. (1) An apparent epidemic of diabetes has occurred--or is occurring--in adults through the world. (2) This trend appears to be strongly related to life-style and socioeconomic change.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

In vitro fertilization in the natural cycle.

In vitro fertilization in the natural or spontaneous reproductive cycle was first described by Edwards and his colleagues in 1980 following the birth of their first natural cycle IVF baby 2 years earlier. Many groups attempted to follow their lead but it was almost ten years later that the next publication of success appeared (Foulot et al, 1989). The concept of IVF in the natural cycle is particularly attractive and so in 1987 our group also started evaluating the technique. Initial success in the patients with tubal lesions was not translated to patients with other infertility indications. Unfortunately the technique as initially developed was relatively inefficient with significant procedural losses at each stage. Over the succeeding four years a number of changes have been introduced and the efficiency considerably improved. Although these changes have improved take-home baby rates, overall pregnancy rates per embryo have not altered and are still lower than spontaneous in vivo pregnancy rates. It is likely that in the future, with current developments in culture techniques and greater understanding of gamete biology, this situation will change significantly.

Female↗
PubMed1992

Dietary intake, exercise, obesity and noncommunicable disease in rural and urban populations of three Pacific Island countries.

Dietary intake surveys of rural and urban communities in three Pacific Island countries were conducted using an adjusted 24-hour dietary recall method. Dietary survey samples were drawn from noncommunicable disease surveys of Melanesians and Indians in Fiji, Micronesians in Kiribati and Melanesians in Vanuatu. Comparisons of total energy and macronutrient intakes and of obesity, hypertension, diabetes mellitus, serum cholesterol and physical activity levels revealed similar rural/urban trends. Urban subjects were more obese than rural ones, had higher prevalence rates of diabetes and hypertension, and generally had higher cholesterol levels. Rural subjects were leaner, suffered less from diabetes and hypertension, and had greater total energy intakes than urban dwellers. Rural people ate a greater proportion of carbohydrates, while urban subjects ate proportionally more protein and fat, apart from the outer Kiribati atolls with high coconut intakes. Rural subjects in all three studies had higher levels of physical activity. These studies provide persuasive evidence that exercise as well as diet has a significant effect on rural/urban differentials in obesity and noncommunicable disease, and that energy intake reflects energy expenditure.

Diet↗
PubMed1992

Operative intervention in active endocarditis in children: report of a series of cases and review.

We describe in detail 14 children (age, less than or equal to 19 years) who underwent operative intervention during active infection of the heart and/or great vessels. The series included five children less than 6 years old, who constitute 10% of all such cases reported in this age group to date. We also review the 132 published reports in which children underwent operative intervention during active endocarditis. We found the following: (1) The survival rate for all cases was 77%. (2) Persistent infection, embolic phenomena, and increasing congestive heart failure were the most frequent indications for operative intervention. (3) Survival rates were independent of the duration of preoperative antibiotic treatment. (4) Survival rates were independent of positive results of cultures of blood or tissue obtained at operation. (5) The perioperative mortality in our series was 14%. (6) Only 67% of patients had conditions thought to predispose to endocarditis. (7) Except for removal of catheter-associated cardiac masses from neonates, operative intervention in active endocarditis was uncommon among children less than 4 years old. (8) Staphylococcus aureus and viridans streptococci were the etiologic agents in the majority of cases of endocarditis requiring operation during active infection in children.

Adolescent↗
PubMed1992

Comparison of the incidence of insulin-dependent diabetes mellitus in childhood among five Baltic populations during 1983-1988.

We have carried out a comparison of the incidence of childhood onset insulin-dependent diabetes mellitus (IDDM) between five populations around the Baltic Sea. These were Finland, Estonia, Latvia, Lithuania and Poland. The risk of IDDM is highest in the world in Finland and also very high in Sweden, on the western and northern side of the Baltic Sea. The risk of IDDM in children on the eastern side of the Baltic Sea has not been known before. The data collection period covered the years 1983-1988. A marked variation in incidence was seen within this relatively small geographical area. Among these five populations, the incidence increased with the latitude. Our present results confirmed the very high incidence of IDDM in Finland. The average age-standardized yearly incidence of IDDM/100,000 was in males under 15 years of age 36.9 in Finland, 10.7 in Estonia, 6.4 in Latvia, 6.5 in Lithuania and 6.0 in Poland. In females the incidence was 31.6, 10.0, 6.9, 7.0 and 6.4 in these five populations, respectively. The differential in incidence in Estonia as compared with Latvia, Lithuania and Poland was statistically significant (P = 0.0002). A slight male excess in incidence was found in countries with higher incidence--Finland and Estonia, but in lower incidence countries the sex ratio was opposite (P = 0.019 for the interaction sex-population). During 1983-1988 the incidence increased significantly in Finland but not in other populations although a large year-to-year variation in incidence was observed in each country, particularly in males. We recorded a peak in IDDM incidence in most of these populations around 1986.

Adolescent↗
PubMed1992

Prevention of type II diabetes by physical training. Epidemiological considerations and study methods.

Disease prevention may be considered at three levels: primary (avoiding disease occurrence), secondary (early detection and reversal), and tertiary (prevention or delay of complications). Physical exercise could potentially contribute to all of these. Metabolic studies suggest the major effect of exercise is at the level of insulin sensitivity/resistance. Therefore, it may have the greatest benefit in primary prevention and in the early stages of the disease. Studies of migrants and of active and inactive professions support this notion. There is also provisional support for the benefit of exercise on metabolic control and prevention or delay of chronic complications in non-insulin-dependent (type II) diabetic patients. In designing a trial of exercise, aspects such as single/multifactorial intervention, the age range of subjects, and choice of outcome measures must be considered. The most widely used methodological tool in assessing physical activity levels in population studies is the activity questionnaire, which is nonreactive, practical, applicable, and accurate relative to other methods. A positive approach to exercise training for both the patient with type II diabetes and the general community appears to be warranted. However, trials examining the efficacy of activity intervention, with independent evaluation of both short- and long-term outcomes, are still needed.

Clinical Trials as Topic↗
PubMed1992

Diabetes in the eastern Mediterranean region.

Socioeconomic development and changes in lifestyles have been accompanied by the emergence of diabetes as a major problem in Eastern Mediterranean countries, but reliable epidemiological data are still scarce and comparability is generally poor. For non-insulin-dependent diabetes (NIDDM) in adults, risk is higher in urban than in rural subjects, and in all populations prevalence increases with advancing age. Whereas several surveys have reported prevalence of the order of 5%, a recent national survey in Oman, which used the full WHO criteria for diagnosis, based upon the 2 hour blood glucose concentration after a 75 g oral glucose load in all subjects, reported a prevalence of diabetes of 10% in those aged 20 years and over. A further 8% of men and 13% of women had impaired glucose tolerance (IGT). Insulin-dependent diabetes (IDDM) was reported to be considerably rarer in Kuwait than in Europe and North America, but some more recent data suggest variability in frequency within the region. IDDM is frequently accompanied by ketoacidosis at diagnosis. For NIDDM, 75% of cases are associated with obesity. Long-term complications appear to occur to the same extent as in Western countries. A recent WHO Task Force meeting has set goals and targets for diabetes prevention and control within the Eastern Mediterranean Region.

Adolescent↗
PubMed1992

Thyroid function in a formerly goitrous community on Karkar Island, Papua New Guinea.

During a survey of noncommunicable disease conducted on Karkar Island, Madang Province in 1986, measures of thyroid function were examined in adult residents of a formerly goitrous village (Gamog) and a neighbouring community (Marup) with no history of iodine deficiency or endemic goitre. In Gamog, almost 20% of males and almost 30% of females had palpable goitre (maximum prevalence at ages 35-54 years) but visible goitres were not encountered. However, thyroid function tests were generally similar in the two groups, suggesting that iodine deficiency is no longer an appreciable problem for adults in Gamog. The persistence of palpable goitre in this village is therefore likely to be a residual effect of previous iodine deficiency. Correction of the iodine deficiency in the Gamog community began with the program of iodized oil injections, which was undertaken in the 1970s. The current lack of iodine deficiency is probably due in the main to dietary change associated with the introduction of the cash economy. This effect may have occurred in many formerly goitrous communities in Papua New Guinea in recent years, although persistence of iodine deficiency in some parts of the country should not be discounted.

Adult↗
PubMed1991

Preoperative and postoperative "aneurysm" associated with coarctation of the aorta.

The reported incidence of aortic aneurysm after surgical repair or balloon angioplasty for aortic coarctation varies widely. To determine the incidence of aneurysm formation after surgery, preoperative and postoperative cineangiograms from 65 patients who underwent operation at age 1.5 +/- 3.4 years were examined. Repair included a prosthetic patch in 14 patients, end to end anastomosis in 28 and subclavian flap in 23. Aneurysm was documented by change in contour or irregularities in contour at the repair site or by abnormal dimensions at the repair site, defined by the ratio of the widest measurement at the repair site to the measurement of the aorta at the diaphragm. An aneurysmal bulge above the ductus diverticulum was identified in 14 (23%) of 60 patients preoperatively; the area showed no change 4.72 +/- 4.07 years after surgery. Significant changes at the repair site were seen in only three patients, all of whom had Dacron patch repair. One patient had a change in contour at the repair site, one had an abnormally high repair site to diaphragmatic aorta ratio and one had a progressive increase in this ratio. Thus, during childhood years, 3 (5%) of 65 patients were diagnosed as having aneurysm at the surgical repair site. In conclusion, 1) comparison with preoperative cineangiograms, especially for aneurysmal bulges above the ductus arteriosus, is essential before an aneurysm can be attributed to coarctation repair by any technique, and 2) aneurysm developed only in patients subjected to Dacron patch repair.

Aortic Aneurysm↗
PubMed1991

Diabetes mellitus in the sultanate of Oman.

In February 1990 a World Health Organization consultancy was undertaken to assess the current impact of diabetes mellitus in Oman. Routine national health statistics suggested that diabetes was the principal diagnosis in approximately 1% of all hospital discharges in 1988. The number of 'new cases' of diabetes treated at hospitals during the same year was 4.8 per 1000 Omani population, representing almost 6000 diabetic patients. In 1989, at the Royal Hospital, Muscat, diabetes was recorded as the principal diagnosis for 2.6% of all discharges, and 6% of those in subjects aged 45 years and over. It is known that the frequency of diabetes is generally underestimated by routine health statistics. Limited ad hoc investigation during the consultancy suggested that approximately 9% of all adult hospital admissions and 12% of adult hospital bed occupancy were associated with diabetes. Thus, diabetes should be considered a priority in a national health strategy for Oman. It is recommended that emphasis be placed upon epidemiological research, education, and the provision of appropriate technology.

Age Factors↗
PubMed1991

Glucose tolerance in Papua New Guinea: comparison of Austronesian and non-Austronesian communities of Karkar Island.

Epidemiological studies in Pacific populations have suggested a relationship between glucose tolerance and proportional Austronesian genetic admixture, with non-Austronesian Melanesians relatively free of glucose intolerance. However, a survey conducted in 1985 demonstrated the apparent emergence of glucose intolerance in a peri-urban non-Austronesian community, casting doubt on this hypothesis. In 1986 glucose tolerance was studied in three village communities on Karkar Island, Papua New Guinea. Two were of Austronesian and one was of non-Austronesian genetic ancestry. Prevalence of diabetes was low in all communities. However, prevalence of impaired glucose tolerance (IGT) was 7% in the more developed Austronesian community, as compared with 2% in the equivalent non-Austronesian group (p less than 0.05). Multiple regression analysis demonstrated not only a highly significant association between 2-h plasma glucose and insulin concentrations (p less than 0.001), but also that for a given value of plasma insulin, 2-h plasma glucose values were lower for non-Austronesian than for Austronesian subjects (males, p less than 0.05, females, p less than 0.01). However, average plasma insulin concentrations were relatively high in the non-Austronesian community, despite lower average plasma glucose concentrations.

Adult↗
PubMed1991

Relationship between prevalence of impaired glucose tolerance and NIDDM in a population.

OBJECTIVE: To study the relationship between the prevalence of impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) across populations of the Pacific Ocean region to assess whether variability in those two proportions followed some predictable pattern related to modernization of life-style and risk factor levels. RESEARCH DESIGN AND METHODS: Prevalence estimates from studies with 75-g oral glucose loads and World Health Organization criteria were age standardized. RESULTS: The linear correlation between IGT and NIDDM prevalence was poor (0.22 in men and 0.24 in women), although it was improved when the outlying data of Micronesian Nauruans and Australian Aborigines were excluded (r = 0.65, P less than 0.01 in men and r = 0.54, P less than 0.01 in women). However, an epidemicity index calculated as the percentage of total glucose intolerance (TGI) made up by IGT (i.e., IGT/TGI) had the strongest correlation with NIDDM prevalence (r = -0.81, P less than 0.001 in men and r = -0.77, P less than 0.001 in women) and also explained more of its variance, with no population having undue influence on the relationship. When IGT/TGI was plotted against NIDDM prevalence for the genetically homogeneous rural (relatively traditional) and urban (modernized) segments of five Pacific island populations, there was a clear tendency for IGT/TGI to decline as the prevalence of NIDDM increased in association with worsening risk factor levels. However, longitudinal data for the high prevalence population of Nauru demonstrated that at least in a stabilizing epidemic, changes in the prevalence of IGT and NIDDM may not be easily predictable. CONCLUSIONS: The epidemicity index may be useful as an indicator of the potential for higher future NIDDM prevalence in whole populations. Populations will probably equilibrate at a certain NIDDM prevalence dependent on the strength of their genetic susceptibility to the disease and their degree of exposure to adverse environmental risk factors, including modern diet, physical inactivity, and obesity.

Adult↗
PubMed1991

Diabetes in adults is now a Third World problem. The WHO Ad Hoc Diabetes Reporting Group.

Since 1988, WHO has been collecting standardized information on the prevalence of diabetes mellitus and impaired glucose tolerance (IGT) in adult communities worldwide. Within the age range 30-64 years, diabetes and IGT were found to be absent or rare in some traditional communities in Melanesia, East Africa and South America. In communities of European origin, the prevalences of diabetes and IGT were in the range of 3-10% and 3-15% respectively, but migrant Indian, Chinese and Hispanic American groups were at higher risk (15-20%). The highest risk was found in the Pima Indians of Arizona and in the urbanized Micronesians of Nauru, where up to one-half of the population in the age range 30-64 years had diabetes. The prevalence of total glucose intolerance (diabetes and IGT combined) was greater than 10% in almost all populations, and was within the range 11-20% for European and U. S. white populations. However, the prevalence of total glucose intolerance reached almost 30% in Arab Omanis and in U. S. blacks and affected one-third of all adult Chinese Mauritians, migrant Indians, urban Micronesians and lower-income urban U. S. Hispanics. In Nauruans and Pima Indians, approximately two-thirds of all adults in the age range were affected. These results lead to three important conclusions. (1) An apparent epidemic of diabetes has occurred--or is occurring--in adult people throughout the world. (2) This trend appears to be strongly related to life-style and socioeconomic change. (3) It is the populations in developing countries, and the minority or disadvantaged communities in the industrialized countries who now face the greatest risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Primary prevention of type 2 (non-insulin-dependent) diabetes mellitus.

Type 2 (non-insulin-dependent) diabetes mellitus is the major form of the disease in all societies. Its public health impact appears to be increasing and the greatest genetic predisposition to the disease is encountered in developing communities. The reduction or elimination of disease in whole populations is a fundamental goal in public health. Whilst several factors are associated with the development of Type 2 diabetes, it is not clear how they cause the disease, if indeed they do, nor whether they act in the same way in all populations. Risk factors may be true determinants of a disease but alternatively they may be associated with its occurrence only by virtue of an innocent relationship with the true causes. Furthermore, known risk factors usually explain only a small proportion of any chronic disease. The role of risk factors in disease causation is therefore of fundamental importance in considering disease prevention. Two alternative strategies for prevention of disease in populations have been proposed. The population strategy seeks to remove the causes of disease in communities as a whole, whilst the high-risk strategy aims to identify subjects at increased risk, and to intervene selectively. The population approach should be tried and carefully evaluated in selected communities at above-average risk of several noncommunicable diseases. However, certain epidemiological features of Type 2 diabetes, including the distributional characteristics of glycaemia and the complications of hyperglycaemia, the clustering of cardiovascular risk factors in the diabetic subpopulation, as well as uncertainties over the causal nature of known risk factors, suggest that a high-risk approach to prevention is also appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus, Type 2↗