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R LaPorte

Publications and source records attributed to R LaPorte.

17 recordsLinked to original sources
PubMed2000

Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group.

OBJECTIVE: To investigate and monitor the patterns in incidence of childhood type 1 diabetes worldwide. RESEARCH DESIGN AND METHODS: The incidence of type 1 diabetes (per 100,000 per year) from 1990 to 1994 was determined in children < or =14 years of age from 100 centers in 50 countries. A total of 19,164 cases were diagnosed in study populations totaling 75.1 million children. The annual incidence rates were calculated per 100,000 population. RESULTS: The overall age-adjusted incidence of type 1 diabetes varied from 0.1/100,000 per year in China and Venezuela to 36.8/100,000 per year in Sardinia and 36.5/100,000 per year in Finland. This represents a >350-fold variation in the incidence among the 100 populations worldwide. The global pattern of variation in incidence was evaluated by arbitrarily grouping the populations with a very low (<1/100,000 per year), a low (1-4.99/100,000 per year), an intermediate (5-9.99/100,000 per year), a high (10-19.99/100,000 per year), and a very high (> or =20/100,000 per year) incidence. Of the European populations, 18 of 39 had an intermediate incidence, and the remainder had a high or very high incidence. A very high incidence (> or =20/ 100,000 per year) was found in Sardinia, Finland, Sweden, Norway Portugal, the U.K., Canada, and New Zealand. The lowest incidence (<1/100,000 per year) was found in the populations from China and South America. In most populations, the incidence increased with age and was the highest among children 10-14 years of age. CONCLUSIONS: The range of global variation in the incidence of childhood type 1 diabetes is even larger than previously described. The earlier reported polar-equatorial gradient in the incidence does not seem to be as strong as previously assumed, but the variation seems to follow ethnic and racial distribution in the world population.

Adolescent↗
PubMed1997

Health insurance and the financial impact of IDDM in families with a child with IDDM.

OBJECTIVE: To examine the health insurance experience and out-of-pocket health care costs of families with a child with IDDM. RESEARCH DESIGN AND METHODS: A case-control study of 197 families with a child with IDDM and 142 control families with no diabetic children was conducted. IDDM-affected families were identified from the Allegheny County IDDM Registry. Brothers and sisters of the parents in the IDDM-affected families were asked to participate as control subjects. Health insurance coverage and the money that families spent on health care services and supplies not reimbursed by insurance (out-of-pocket costs) were assessed by questionnaire. RESULTS: No difference was found between the IDDM-affected and control families in the percentages with or without insurance. Families with low household incomes ($10,000-$19,999) were at the greatest risk for having no insurance. While coverage provided by private plans was similar between the IDDM-affected and control families, many families had no reimbursement for insulin (10%), syringes (10%), or blood testing strips (30%). Out-of-pocket expenses were 56% higher in the IDDM-affected families than in the control families. Seventeen percent of the IDDM-affected families had expenses over 10% of their household income. This particularly affected families with low household incomes. Pre-existing illness clauses and insurance denial affected only a small proportion of the case families. CONCLUSIONS: These data illustrate that most families with a child with IDDM have health insurance, yet still incur larger out-of-pocket health care costs than do families without the presence of diabetes. IDDM-affected families likely face a number of economic decisions regarding health insurance and the use of health care.

Adolescent↗
PubMed1993

An epidemiologic study of paternity after cryptorchidism: initial results.

Paternity has been studied among married men who were formerly cryptorchid. Forty-one of 52 formerly unilateral cryptorchid men were married, 10 of 11 bilaterally cryptorchid and 36 of 42 control men. Thirty-two of the 41 of the unilateral group (78%) had fathered children, 6 of 10 in the bilateral group (60%) and 24 of 36 controls (67%). These limited data from the initial phase of this study of paternity after cryptorchidism do not show any correlation between paternity or time of unprotected intercourse to conception and age of surgery or pretreatment testicular size or location. However, these data suggest that paternity is not decreased after unilateral cryptorchidism.

Adult↗
PubMed1993

A review of the recent epidemiological data on the worldwide incidence of type 1 (insulin-dependent) diabetes mellitus. World Health Organization DIAMOND Project Group.

Nearly 70 registries from more than 40 countries have collected and published incidence data of childhood Type 1 (insulin-dependent) diabetes mellitus up to the end of the 1980s. The majority of incidence data comes from regions of high incidence i.e. from Europe and North America. All these published data facilitate the descriptive comparison of incidence and variation of the occurrence of Type 1 diabetes roughly throughout the northern hemisphere. The aim of this paper is to review and compare the most recent epidemiology data on the incidence of Type 1 diabetes among children under the age of 15 years. A clear difference in incidence appeared between northern and southern hemisphere with no countries below the equator having an incidence greater than 15.0 per 100,000. In contrast above the equator the disease is common. Between continents the variation in incidence showed that the lowest incidences were found in Asia, followed by Oceania (Australia and New Zealand), South and North America, and the highest rates were in Europe. The incidence varied from 0.6 per 100,000 in Korea and Mexico to 35.3 per 100,000 in Finland showing prominent worldwide variation in incidence of Type 1 diabetes. The largest intracontinental variation in incidence appeared in Europe, varying from the highest in Finland to the lowest (4.6 per 100,000) in northern Greece. The highest incidence in the world was in northern Europe, but within the continent scale there were some striking exceptions from the overall level of incidence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Epidemiology of the post-polio syndrome.

A late-onset syndrome, consisting of muscle weakness, muscle pain, and unaccustomed fatigue, has been reported with increasing frequency among former poliomyelitis patients. A population-based cohort of poliomyelitis patients from Allegheny County, Pennsylvania, was traced and surveyed to estimate the prevalence and incidence and to identify determinants of the post-polio syndrome. A questionnaire validated in clinical examinations of 40 cohort members was used in the survey. The prevalence of the post-polio syndrome was 28.5% of all paralytic cases (95% confidence interval 24.4-32.6). The risk of post-polio syndrome was significantly higher among patients who sustained substantial permanent impairment after polio and among females. The incidence did not vary with age at acute onset, acute severity, or level of physical activity after recovery. The strongest determinant of post-polio syndrome onset was the length of the interval following the acute illness, with incidence peaking at 30-34 years. Of all cases of post-polio syndrome, 79% reported no major change in impairment status since onset. This study demonstrates that poliomyelitis patients are not equally susceptible to post-polio syndrome within the interval of 30-40 years after the original illness. For syndrome cases, the onset was associated with new neuromuscular symptoms and functional changes but not with major new impairment.

Acute Disease↗
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↗
PubMed1990

Magnetic resonance imaging (MRI) effects on rat pineal neuroendocrine function.

This study investigated the effects of MRI on receptor-mediated activation of pineal gland indole biosynthesis. Exposure of rats to MRI reduced the effects of isoproterenol on pineal serotonin and N-acetylserotonin levels suggesting that strong magnetic fields and/or radio-frequency pulsing used in MRI inhibited beta-adrenergic activation of the gland. There was no effect of MRI on saline controls.

Animals↗
PubMed1990

Day-night differences in the vesicle populations of nerve terminals in the rat and chick pineal gland.

Day-night differences in the ultrastructure of pineal neuronal elements were quantitated in the rat and the chick--two species that exhibit important differences in adrenergic control of melatonin synthesis. Area densities of small clear vesicles (40-60 nm) and small dense-cored vesicles (40-60 nm) in nerve terminals were significantly reduced during the night in the rat. In the chick, there were no day-night differences in the frequency of clear vesicles, but the number of small dense-cored vesicles tended to be greater at night. There was no effect of day-night sampling on area densities of large dense-cored vesicles (80-120 nm) in either species. These findings are consistent with biochemical evidence for day-night species differences in the adrenergic control of pineal function.

Animals↗
PubMed1990

Perforating eye injury in Allegheny County, Pennsylvania.

From 1980 through 1986, acute perforating eye injury (ICD codes 871.0-871.9) was diagnosed in 345 residents of Allegheny County, Pennsylvania. The mean incidence rate was 3.49 per 100,000 person years. There was no significant change in incidence over the seven-year period. The largest number of injuries occurred among individuals working with tools, of which 47 percent were occupational. Males had a 6.5-fold risk of injury relative to females. Blacks had a risk of 2.2 times that of Whites, mainly due to an excess of assaultive injuries. Individuals who had had recent ocular surgery accounted for 4.6 percent of cases overall, and for 31.6 percent of cases in those over age 60.

Adolescent↗
PubMed1982

Pittsburgh diabetes mellitus study. II. Secondary attack rates in families with insulin-dependent diabetes mellitus.

Family history data were collected in 1203 consecutive admissions of insulin-dependent diabetes mellitus cases to the Children's Hospital of Pittsburgh between Dec. 31, 1964 and Jan. 1, 1981. This report deals with two issues: the closeness in time of dates of onset of diabetes in multiple sibling case families and the similarity of ages of onset within these families. The age-specific incidence rates among siblings were 6-18 times higher than in the general population. Contrary to other reports, this study does not find an increased risk to siblings during the first year or two after the onset of the index diabetic case. The mean duration between cases is 6.1 years. Fitting a log-normal distribution to the periods between cases verified the long median incubation period (4.35 years) with a high degree of variability (dispersion factor = 3.38). However, the log-normal was not a good fit to the data (p less than 0.005). There is a significant correlation for age of onset for pairs of affected siblings within families (0.25). However, it is shown that the similarity in age of onset within families may be a function of the greater similarity to ages of siblings within a family. It is noted that secondary cases are more often younger children in the family, particularly so if the index child is of school age at the time of onset.

Adolescent↗
PubMed1981

Plasma testosterone, high density lipoprotein cholesterol and other lipoprotein fractions.

High density lipoprotein (HDL) cholesterol levels are strongly related to risk of heart attack. Identification of determinants of high density lipoprotein cholesterol may provide important information concerning the cause of heart disease. The relation between one possible determinant, testosterone, and high density lipoprotein cholesterol and other lipoprotein fractions was evaluated in 247 middle-aged men. The results indicate that testosterone levels (both free and total) were positively correlated with high density lipoprotein cholesterol (r = +0.24, p less than 0.01) and negatively correlated with triglycerides and very low density lipoprotein cholesterol. The association between testosterone and high density lipoprotein cholesterol could not be explained by intake of alcohol, obesity, age, smoking or physical activity. Furthermore, the relation of testosterone to HDL cholesterol was independent of the relation of testosterone to very low density lipoprotein (VLDL) cholesterol or triglycerides.

Age Factors↗
PubMed1981

The relationship between alcohol consumption, liver enzymes and high-density lipoprotein cholesterol.

High-density lipoprotein (HDL) cholesterol concentrations are inversely related to risk of heart attack. Alcohol consumption is a primary factor related to increased HDL concentrations. We investigated HDL cholesterol before and after cessation of high alcohol consumption in alcoholics. Men admitted to an alcohol detoxification hospital had a mean HDL cholesterol level of 85 mg/dl, which is almost twice that found in the general population. After 4 days of treatment, HDL cholesterol levels decreased an average of 12.5 mg/dl. The decrease was directly correlated with the initial HDL cholesterol levels and inversely correlated with the change in triglyceride levels. Alcoholics who abstained for at least 1 month had HDL cholesterol concentrations similar to those of the general population. The increased HDL cholesterol levels in the alcoholics were highly correlated with liver enzyme concentrations, especially SGOT. The results suggest that alcohol increases HDL cholesterol concentrations through hepatic microsomal enzyme induction.

Adult↗
PubMedDate not supplied

Exposure to superantigens as an immunogenetic explanation of type I diabetes mini-epidemics.

Insulin-dependent diabetes mellitus (IDDM) is considered to be an autoimmune disease. Autoimmune diseases result from the breakdown of self-tolerance elicited by environmental factors on a susceptible genetic background. This reduced tolerance allows immunocompetent cells to attack normal structures present on an individual's tissues. The study of the T cells present in the islets of patients who died at the onset of the disease allowed the recognition of "superantigens" as etiopathogenetic factors in the development of IDDM. Since superantigens are the product of bacteria or viruses able to quickly stimulate a large number of the peripheral T cells sharing the same T cell receptor V beta segments once presented by certain HLA class II molecules, a number of observations in genetics, immunology, virology and epidemiology can now find a unifying explanation.

Adolescent↗