Search PubMed⌕ Search

Biomedical subjects

H King

Publications and source records attributed to H King.

At least 91 records · Page 5Linked to original sources
PubMed1988

Type 1 (insulin-dependent) diabetes in Tasmania: prevalence and apparent regional differences.

The results of a cross-sectional study of Type 1 (insulin-dependent) diabetes in the total population of Tasmania are described. Tasmanians, predominantly of British origin, live in a temperate island situated to the south-east of mainland Australia. For males and females respectively, prevalence in 1984 was 1.1 +/- 0.1 and 0.9 +/- 0.1 per 1,000 at all ages, 0.6 +/- 0.2 and 0.5 +/- 0.2 per 1,000 in subjects aged 0-14 years, rising to 1.2 +/- 0.2 and 1.1 +/- 0.2 per 1,000 in those aged 0-29 years. Prevalence in the 0-19 year age range was 0.8 +/- 0.2 per 1,000 in both sexes. Prevalence fell in both sexes from the third decade of life. A statistically significant excess in prevalence was found in the urban, as compared with the rural, sector of the community. The urban relative risk was greatest in subjects aged 10-19 years. According to reported month of onset (commencement of insulin treatment) there was a suggestion of seasonal trend in the rural, but not in the urban subjects. Longitudinal studies of Type 1 diabetes in Tasmania are now required if these findings are to be confirmed, and their possible aetiological implications explored.

Adolescent↗
PubMed1988

Electrocardiographic abnormalities amongst Melanesian and Indian men of Fiji: prevalence and associated factors.

Electrocardiograms were performed on 427 Melanesian and 391 Indian males aged 30-69 years surveyed in 1980. The age-adjusted prevalence of abnormalities in Minnesota coding suggesting coronary arterial disease was: Indians - 17.1%, Melanesians - 9.1%. This difference was significant at P less than 0.001. For the Melanesians body mass index, plasma uric acid, cholesterol and triglyceride and systolic blood pressure showed significant positive associations with electrocardiographic abnormalities in a univariate analysis, but only the plasma uric acid level was independently associated with such abnormalities following adjustment for these other factors in a multivariate analysis (P less than 0.001). For the Indians body mass index, systolic blood pressure, the presence of diabetes, urban residence and physical inactivity were positively associated with electrocardiographic abnormalities in the univariate analysis, but only body mass index (P less than 0.01), systolic blood pressure (P less than 0.01), and the 2-hour glucose level (P less than 0.01) were independently associated with such abnormalities when adjustment was made for the levels of the other factors.

Adult↗
PubMed1988

Aetiology. Non-insulin-dependent diabetes.

NIDDM appears to be a disease of complex aetiology. Although specific genetic markers for the disease have yet to be defined, there is clear evidence for genetic predisposition, with high concordance in monozygous twins. However, concordance is incomplete, and there are therefore additional, non-genetic, mechanisms which are responsible for increasing the risk of the disease in susceptible subjects. At the present time, the most plausible environmental precipitants appear to be the inter-related triad of obesity, low levels of habitual physical exercise and diet. The power of environmental determinants, and their interaction one with another, may also be subject to individual genetic determination, and may not act in a similar manner in all populations. Some non-Caucasian populations, which have undergone marked sociocultural change, are now extremely susceptible to NIDDM. This is probably the result of evolutionarily heightened genetic predisposition, compounded by strong environmental influence resulting from the recent changes in their human ecology. Since prevalence is strongly related to age, NIDDM also represents a growing problem to the world's industrialized societies, for many of which longevity is now the major demographic trend. Research into the aetiology of NIDDM must not only continue, it must also explore new directions, and attain greater scientific depth and sophistication, if it is to make a useful contribution to the eventual prevention and control of the disease.

Diabetes Mellitus, Type 2↗
PubMed1988

Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji.

Plasma uric acid was investigated in a population survey on diabetes and cardiovascular risk factors among Melanesians and Asian Indians in Fiji in 1980. Plasma uric acid levels were elevated in men and women with impaired glucose tolerance in both ethnic groups. The lowest plasma uric acid levels were found in diabetic patients, especially in diabetic men. Even though obesity was positively associated with plasma uric acid, it did not explain the high plasma uric acid level in persons with impaired glucose tolerance. Body mass index had a significant and independent impact on plasma uric acid levels both in nondiabetic and diabetic men and women. The strongest predictor of plasma uric acid in the multiple regression analysis in our study populations was plasma creatinine: it alone explained 9% of the variation in men and 2% in women; and 24% in Melanesians and 5% in Asian Indians. Our findings suggest a strong renal involvement in the balance of plasma uric acid and may also reflect certain dietary patterns, such as a high intake of protein, fats, and certain local vegetables. Although the prevalence of hyperuricemia was high, 27% in both Melanesian men and women, 22% in Asian Indian men, and 11% in Asian Indian women, clinical gout was uncommon. Many predictor variables and their interactions were analyzed along with the reasons for the high plasma uric acid levels in persons with impaired glucose tolerance and for the low plasma uric acid levels in diabetic patients.

Adult↗
PubMed1988

Benign and malignant cellular blue nevus. A clinicopathological study of 30 cases.

The clinical and pathological features of 29 cellular blue nevi (CBN) and one malignant cellular blue nevus from our hospital files were reviewed. Although the sacrococcygeal region/buttock was the commonest single site, the majority of CBN occurred on the limb peripheries. Two-thirds of patients were under the age of 40 years. Follow-up of a mean of 7 years did not reveal any evidence of malignancy. Four histological subtypes were recognized: mixed biphasic, alveolar, fascicular or neuronevoid, and atypical varieties. One case developed a benign nodal metastasis. In one case, malignancy arose within a CBN. The importance of recognizing the variety of patterns, the benign behavior of the atypical variety, and the criteria for malignancy are herein discussed.

Adolescent↗
PubMed1988

Management of asymptomatic intracardiac missiles using echocardiography.

A child sustained a low-velocity airgun pellet injury to the left ventricle. No cardiovascular compromise was produced. The foreign body was localized by two-dimensional echocardiography to the left ventricular chamber near the mitral valve, and subsequently removed through a left atriotomy incision. In asymptomatic patients, missiles clearly embedded within a chamber wall may be observed; all others should be removed. Two-dimensional echocardiography is recommended for localization.

Child↗
PubMed1988

Microbiological profile of the cervix in 1,000 sexually active women.

One thousand consecutive women who attended the Richmond Family Planning Association Clinic and who were to undergo a vaginal examination were asked to participate in a large prospective microbiological study. Participants were questioned about their sexual activity during the previous 12 months and any apparent signs of sexually transmitted disease. On examination the cervix was inspected for evidence of inflammation, ectopy or discharge and cervical swabs were taken microbiological assessment. Chlamydia trachomatis was isolated in 5.1% of women tested while Ureaplasma urealyticum and Mycoplasma hominis were found in 48.8% and 16.4% of women respectively. Significant associations were found between the number of sexual partners during the previous 12 months and the incidence of all 3 organisms. The carriage rate of the genital mycoplasmas was significantly affected by the type of contraception. In addition the association between the presence of the genital mycoplasmas and pelvic and cervical abnormalities was determined.

Animals↗
PubMed1988

Case mix management in context.

The advent of DRGs has demanded that hospitals account for all costs and resources. A case mix management system must take into consideration every component of a total managerial accounting strategy. This article discusses the factors healthcare institutions need to address to achieve a completely interfaced accounting system.

Accounting↗
PubMed1988

Trends in the prevalence and incidence of diabetes: insulin-dependent diabetes mellitus in childhood.

The results of this international collaboration emphasize the importance of population-based incidence registries which, similarly to cancer research, became an indispensable tool in etiological investigation and health-delivery planning in the area of insulin-dependent diabetes mellitus (IDDM). Future collaboration within the DERI project will help to monitor the geographical and temporal variability of IDDM incidence. This collaborative effort may provide a frame for more detailed international studies of etiology and natural history of the disease, as well as for evaluation of the costs of IDDM and future prevention programmes.

Adolescent↗
PubMed1988

Trends in the prevalence and incidence of diabetes: non-insulin-dependent diabetes mellitus.

The revision of the classification of diabetes mellitus, to differentiate clearly between insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM), and the provision of unambiguous guidelines for diagnosis (1) constitute important recent developments in diabetes epidemiology. However, our knowledge even of the prevalence of NIDDM remains surprisingly incomplete for many areas of the world. Whilst NIDDM may still be uncommon in rural Africa, prevalence has been reported as approximately 10% in blacks in the United States, indicating a need for more information regarding the prevalence of NIDDM in urban Africa. There is also little information with regard to urban communities in Latin America. The highest prevalence of NIDDM is found in certain indigenous North American and Western Pacific societies. In extreme cases approximately one-third of the adult population now suffers from the disease. NIDDM is also common (prevalence approximately 5%) in Europe and in communities of European origin. Data from the United States suggest that approximately one-fifth of white North Americans can expect to develop NIDDM if they live to the seventh decade of life. Of populations of South-East Asian ethnicity, Indians appear to be the most susceptible. Indian migrants to Fiji, South Africa and South America all demonstrate prevalence of NIDDM of 10% or more. Whilst it was formerly believed that Chinese were rarely affected by NIDDM, recent reports cast some doubt on this. Prevalence of NIDDM in the Western Pacific varies widely. However, with the possible exception of certain Melanesian populations, prevalence is high in all communities which have abandoned their traditional lifestyle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

The National Mortality Survey of China: implications for cancer control and prevention.

Findings of the People's Republic of China (PRC) Cancer Mortality Survey were reviewed for historic background, implications for etiologic-interventive clues, and transitional experience among Chinese migrants. Rates, calculated using the 10% sample census, were all age-adjusted. Cancer comprised about 10% of total deaths, with stomach cancer as the top killer. Minority rates, adjusted to the 1964 China population, ranged from 26.7 (Miao) to 127.5 (Kazak). Multiple high-risk areas were noted for cancer of the esophagus and other sites, and urban rates exceeded those for rural areas. The transitional experience among U.S. Chinese was examined at geographic-generational levels. Among U.S. Chinese, downward trends were found for cancers known as to be high-risk for Asian-Chinese (nasopharynx, esophagus, liver, uterus, and perhaps stomach). The reverse was true for low-risk sites (colon, lung leukemia, and female breast). Lung and colorectal cancers among females were the only major sites for which foreign-born Chinese had higher rates than U.S.-born.

Adolescent↗
PubMed1987

Preoperative two-dimensional echocardiographic prediction of prosthetic aortic and mitral valve size in children.

Preoperative two-dimensional echocardiograms (2D-ECHOs) were done on 18 patients to determine the accuracy of assessing the mitral and aortic anulus diameter in children undergoing valve replacement. Fourteen patients underwent primary valve replacement and four underwent repeat valve replacement. The mean age was 11.5 years (range 2 to 17 years). The 2D-ECHO measured mitral or aortic valve anulus was compared with the external diameter of the largest prosthetic valve that could be inserted. There was a strong correlation (r = 0.99, p less than 0.001, SEE = 1.0 mm) between the 2D-ECHO measurements and the prosthetic valve size in patients undergoing primary valve replacement, but the correlation (r = 0.16, p = NS) was poor for those undergoing repeat valve replacement. In conclusion, 2D-ECHO prediction of prosthetic mitral and aortic valve size is accurate in children undergoing primary valve replacement but is poor in those undergoing repeat valve replacement.

Adolescent↗
PubMed1987

Isthmus flap aortoplasty. A new approach to long-segment coarctation repair.

While not the answer for every patient with coarctation, isthmus flap aortoplasty offers excellent results for infants with long-isthmus segment defects that are the most difficult to repair by end-to-end or subclavian flap techniques. Isthmus flap aortoplasty has been used in six patients with long-isthmus segment coarctations. The surgical approach to coarctation depends on the local anatomical features in each infant. The standard subclavian flap technique seems to be quite adequate for most infants with short-isthmus coarctation. The decision about which technique to use, however, is made by the surgeon at the OR bed. The isthmus flap technique has been quite useful for this group of infants with coarctation and has given excellent results. The technique eliminates most, if not all, of the limitations of the subclavian flap technique and belongs in the armamentarium of a pediatric surgeon for difficult-to-manage patients.

Aorta, Thoracic↗
PubMed1987

Long-term fate of the diaphragm surgically plicated during infancy and early childhood.

Favorable early results have been reported utilizing transthoracic diaphragmatic plication in symptomatic children with phrenic nerve injury. However, little has been published about the late functional results of this technique. Since 1976, 10 of 3,000 patients operated on for congenital heart disease have sustained phrenic nerve injury with subsequent respiratory embarrassment. An additional patient sustained phrenic nerve injury as a result of birth trauma. The diagnosis was confirmed by paradoxical diaphragmatic motion on fluoroscopy. All but 2 patients were less than 5 months old at the time of diaphragmatic plication, and the average weight was 5.4 kg. The indication for diaphragmatic plication was inability to wean from the ventilator in 8 of the 11 patients and persistent postoperative tachypnea, stridor, and CO2 retention in the remaining 3 patients. A more aggressive approach to diagnosis and operative treatment since 1980 has resulted in a substantially shorter duration of endotracheal intubation and a shorter stay in the intensive care unit. Diaphragmatic fluoroscopy 1 to 7 years postoperatively has demonstrated return of normal function in 6 of 6 patients studied.

Age Factors↗