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PubMed2000

Utilization of Alzheimer's disease community resources by Asian-Americans in California.

Alzheimer's disease is as prevalent among Asian ethnic minority groups as among Caucasians. We explored Asian groups' utilization of available Alzheimer's disease services in California, using a uniquely large sample of Asian-Americans. The Minimum Uniform Dataset includes data from nine California Alzheimer's Disease Diagnostic and Treatment Centers. Of the 9,451 cases included in the Minimum Utilizable Dataset, 4.2% were Asian (primarily Chinese), 0.8% Filipino, 0.3% Pacific Islander, and 75.9% Caucasian. In comparison to their numbers within the nine California countries served, Asian ethnic elders were underrepresented in enrollment by approximately 50%, except at one center where all staff were bilingual. The centers referred a significantly greater proportion of Asian than Caucasian patients for financial help (47.8 vs. 7.4%, P < 0.001), case management (47.8 vs. 22.3%, P < 0.001), and to Alzheimer's disease day care (41.3 vs. 28.4%, P < 0.05). A significantly greater proportion of Asian caregivers received referrals to caregiver resource centers (32.6 vs. 61.3%, P < 0.001) and financial help (29.6 vs. 4.7%, P < 0.001). A smaller proportion of Asian patients received referrals to home health services than Caucasians (4.3 vs. 14.9%, P < 0.05). Filipino patients were also referred more frequently to financial assistance than Caucasians (P < 0.05). Asians and Pacific Islanders under-enroll at centers specializing in AD care. Bilingual staff at centers specializing in dementia care, training for community physicians who treat these patients, and establishment of caregiver support groups within Asian and Pacific Islander communities may enhance the enrollment of these elders. AD care centers in areas supporting Asian and Filipino families may need to concentrate resources on providing financial assistance in case management.

Aged↗
PubMed2005

Procedural success and complications following percutaneous coronary interventions among Asians and Pacific Islanders.

BACKGROUND: Although Asians and Pacific Islanders (PI) make up the fastest growing ethnic group in the United States, little is known about the clinical characteristics, procedural success, and procedure-related complications of those who undergo percutaneous coronary interventions (PCI). HYPOTHESIS: This study investigated PCI procedural success and procedural complications among PI and Asian patients in comparison with Caucasians. METHODS: We examined clinical characteristics, procedural success (post-PCI lesion < 50%) and procedure-related complications (hemorrhage, renal failure, myocardial infarction, stroke, bypass surgery, death) for all patients undergoing PCI at our hospital from January 1999 to June 2003. RESULTS: Overall, 2,598 PCIs were performed--1,058 (39%) in Caucasians, 1,163 (43%) in Asians, and 377 (14%) in PIs. The mean age of PIs (59 +/- 11 years) was significantly lower than that of Caucasians (65 +/- 12 years) and Asians (66 +/- 12 years). The mean body mass index (26 +/- 5) of Asians was significantly lower, while that of PIs (31 +/- 7) was significantly higher than that of Caucasians (28 +/- 6). More Asians (33.3%) and PIs (40.5%) had diabetes mellitus than did Caucasians (19.9%). More Asians (71.6%) and PIs (76.1%) had hypertension than did Caucasians (61.9%). Renal failure was more prevalent in Asians and PIs (6.0 and 7.4%, respectively) than in Caucasians (3.8%). Other than a higher prevalence of disease involving the left anterior descending vessel in Asians (56.4%) compared with Caucasians (50.4%), angiographic features across the three races were similar. There was no significant difference in procedural success (approximately 94%) or procedure-related complications among Caucasians (6.4%), Asians (7.1%), and PIs (4.3%). CONCLUSION: Although PIs and Asians have a substantially higher burden of comorbidities than Caucasians, race does not appear to influence PCI procedural success or procedure-related complications.

Aged↗
PubMed2006

Self-harm in the UK: differences between South Asians and Whites in rates, characteristics, provision of service and repetition.

BACKGROUND: Rates of self-harm appear high in South Asian young women in the United Kingdom (UK) although previous studies were mostly small. Data on treatment and outcomes for South Asians are lacking. This study compared rates of self-harm, socio-demographic and clinical characteristics, provision of services and risk of repetition by ethnicity. METHOD: A prospective cohort of adult self-harm attendees (n = 7185), aged 15 and over presenting to four emergency departments in the cities of Manchester and Salford, UK over a 4-year period. RESULTS: The study included 299 South Asians. South Asian women aged 16-24 years were more likely to self-harm than Whites of the same age group (1010.9 vs. 754 per 100,000). Across all age groups the rates of self-harm were lower in South Asian men compared to White men and to South Asian women. South Asian women were significantly more likely to report relationship problems within the family than White women (32% vs. 19%, P = <0.001). South Asians were less likely than Whites to report depressive symptoms and to be offered specialist mental health services (Rate ratio = 0.75), and more likely to be referred back to the GP (Rate ratio = 1.83). South Asians were less likely to attend with a repeat episode (Rate ratio = 0.56). CONCLUSIONS: Young South Asian women are at high risk of self-harm, but their clinical risk appears to be lower in terms of the accepted contextual factors contributing to risk. Potentially useful service provision may include an interpersonal problem solving approach although to be effective, interventions would need to be acceptable to South Asian women and culturally appropriate.

Adolescent↗
PubMed2003

A new paradigm for the aging Asian face.

Traditionally, Asians have been thought to age more gracefully than Caucasians. The resistance to aging in the Asian patient was credited to the thicker dermis of Asian skin that contains greater collagen and the darker pigment that protects against photoaging. Although these statements are true, the authors propose a new paradigm that explains how the illusion of Asian youthfulness may be understood. The "baby model" purports that the Asian face has many attributes similar to an infant, including a wider and rounder face, higher eyebrow, fuller upper lid, lower nasal bridge, flatter midface, apparently more protuberant lips, and more receded chin. These commonalities between the infant and the Asian compel the viewer to perceive the Asian face as more youthful. However, the Asian face is subjected to a greater amount of gravitational force due to weaker skeletal support, heavier soft tissue, larger amount of malar fat, thicker skin, and a weaker chin. Facial rejuvenative surgery should always be cognizant of the propensity of the Asian skin to unfavorable healing, need for greater tissue suspension, and more conspicuous temporal alopecia. Asian aesthetics that differ and converge with Western ideals are reviewed so that the Western surgeon in particular can comprehend the Asian conception of youthful beauty.

Adipose Tissue↗
PubMed2005

Leisure time, non-leisure time, and occupational physical activity in Asian Americans.

PURPOSE: Asian American immigrants' risk of heart disease, diabetes, and obesity increase with duration of residence in the United States (US). Regular physical activity reduces the risk of these diseases, yet little is known about physical activity in Asian Americans and how it changes after immigration. METHODS: Data from the 2001 California Health Interview Survey, which oversampled Asian Americans, were analyzed to investigate the effects of ethnicity, nativity, and years in the US on leisure time physical activity (LTPA), non-leisure time physical activity (NLTPA), and occupational physical activity. A total of 4226 Asian Americans and 29,473 US-born non-Asians were included. RESULTS: Asian Americans were much less likely to meet recommended levels of LTPA than US-born non-Asians (odds ratio [OR], men=0.51, 95% confidence interval [CI], 0.42, 0.61, OR, women = 0.48, 95% CI, 0.40, 0.57). Foreign-born Asians were least likely to participate in LTPA; LTPA increased as years in the US increased. After accounting for NLTPA, Asian Americans had significantly lower estimated weekly energy expenditure than US-born non-Asians. CONCLUSIONS: Asian Americans, especially immigrants, are at risk for low levels of LTPA and high levels of physical inactivity. NLTPA does not offset these lower levels of LTPA. Increasing physical activity is key to protecting the health of this rapidly growing population.

Acculturation↗
PubMed1997

Impact of breast cancer on Asian American and Anglo American women.

This pilot study constitutes the first exploration of the impact of breast cancer on Asian American women. Three hypotheses guided this study: (1) Asian American women would choose breast conserving therapy and breast reconstruction at a lower rate than the Anglo American women due to cultural differences in body image, (2) Asian American women with breast cancer would express psychological distress somatically and Anglo American women would express distress emotionally, and acculturation levels of the Asian American women would modify the expressions of distress such that women with high acculturation will express distress more emotionally and less acculturated women would express distress more somatically, and (3) Asian American women would seek assistance for psychosocial problems at a significantly lower rate than Anglo women. Ethnicity, age, and levels of acculturation were found to be significant variables that had to be considered simultaneously. The three hypotheses were only partially supported: (1) Asian American women chose breast conserving therapy and adjuvant therapy at a significantly lower rate than the Anglo American women, (2) Contrary to the hypothesis, somatization did not appear to be a dominant form of symptom presentation for Asian American women regardless of level of acculturation, and (3) Asian American women sought professional assistance for psychosocial problems at a significantly lower rate than Anglo women. Asian American women reported using different modes of help-seeking behavior for emotional concerns and receiving different sources of social support than the Anglo American women. Cultural interpretations of the findings are offered to explain the differences in the physical, emotional, and social responses to the breast cancer experience of Asian American women compared with the Anglo Americans, and notably between the Chinese- and Japanese Americans as well. The findings of this study warrant more refined exploration in order to improve the medical, psychological and social outcomes for Asian American women with breast cancer.

Acculturation↗
PubMed2003

Differences in survival on peritoneal dialysis between oriental Asians and Caucasians: one center's experience.

BACKGROUND: Recently it has been suggested that the survival of dialysis patients may differ among different races. Both registry data and data from Asian countries indicates that Asians on peritoneal dialysis may survive longer than their Caucasian counterparts. In the present study, we performed a detailed analysis of survival differences between oriental Asians and Caucasians on peritoneal dialysis in our multiethnic, multicultural program. METHODS: Retrospectively we analyzed the survival data for patients who started peritoneal dialysis after January 1, 1996 and before December 31, 1999, in our hospital. They were followed for at least for two years. Excluded from the present analysis were those who survived for less than three months on peritoneal dialysis. The patient demographic characteristics, comorbidities, and residual renal function at the start of dialysis were collected. Indices for adequacy of dialysis were collected 1-3 months after the initiation of dialysis. Actuarial survival rates were determined by the Kaplan-Meier method. The Cox proportional hazards model was used to classify risk factors for a high mortality. RESULTS: There were 87 Caucasians and 29 Oriental Asian peritoneal dialysis patients. No differences were found in age, gender, primary renal disease, and residual renal function between the two groups. The Caucasians had significantly higher body surface area and urea volume and higher incidence of cardiovascular diseases. Even with slightly higher dialysis dose, the peritoneal creatinine clearance was significantly lower among the Caucasians than among Asians. There was no difference in the peritoneal D/P value between the two groups. However, compared to the Caucasians, the 24hr peritoneal fluid removal and total fluid removal volumes were significantly lower in the Asian patients. The one, two, three and four year survival rates were 95.8%, 91%, 86% and 80% for Asians and 91.3%, 78.1%, 64.7% and 54.1% for Caucasians. Significant predictors for a higher mortality were the presence of cardiovascular disease (42% increase in risk), Caucasians (39% increase in risk) and older age (37% increase in risk for age older than 65). CONCLUSIONS: Our study confirms that oriental Asians on peritoneal dialysis patients survive much longer than their Caucasian counterparts; this was partly due to the fact that Asian patients have less cardiovascular disease when they began peritoneal dialysis. Due to their smaller body size, the Asians tended to have a higher peritoneal small solute clearances despite their smaller dialysis doses, indicating that, to achieve the same solute clearance targets, Asians need a smaller dialysis dose compared to Caucasians.

Asian People↗
PubMed2002

Is the blood pressure of South Asian adults in the UK higher or lower than that in European white adults? A review of cross-sectional data.

The objective of the study was to review published evidence on whether blood pressure levels and the prevalence of hypertension are higher or lower in South Asian adults living in the UK as compared to white populations. A systematic literature review was carried out using MEDLINE 1966-2001, EMBASE 1980-2001, and citations from references. A total of 12 studies were identified. The data showed important differences between studies in terms of age and sex of samples, definition of South Asians (Indian, Pakistani and Bangladeshi) and methods of evaluating blood pressure. Seven studies reported lower mean systolic blood pressures, while seven studies showed higher diastolic pressures in South Asian men compared to white men. In women, six of nine studies showed lower systolic blood pressures, while five reported higher diastolic pressures. For prevalence of hypertension, five of 10 studies reported higher rates in South Asian men than in white men. Two of six studies showed higher prevalence rates in South Asian women. Overall, the most representative sample and up-to-date data came from the Health Survey of England 1999. Both blood pressure and the prevalence data show important differences between South Asian subgroups, yet most studies combined them. The data also showed a geographical variation between London (comparatively high blood pressure in South Asians) and the rest of the UK (comparatively low or similar blood pressure). Bangladeshis had low blood pressure and body mass index (BMI). In other South Asian subgroups, low blood pressure and the low BMI did not always coincide. To conclude, the common perception that blood pressure in South Asians is comparatively high is unreliable-the picture is complex. Overall, blood pressures are similar but there is stark heterogeneity in the South Asian groups, with slightly higher blood pressure in Indians, slightly lower blood pressure in Pakistanis, and much lower blood pressure in Bangladeshis. Variations in study methods, body shape, size and fat, and in the mix of South Asian groups probably explain much of the inconsistency in the results.

Adult↗
PubMed1996

Birthweight outcomes among Asian American and Pacific Islander subgroups in the United States.

BACKGROUND: Information on birth outcome among the Asian and Pacific Islander populations in the US is limited. This report examines the risks of moderately low (MLBW) and very low birthweight (VLBW) among six Asian subgroups (Chinese, Japanese, Fillipinos, Asian Indians, Koreans, Vietnamese) and three Pacific Islander subgroups (Hawaiians, Guamanians, Samoans) as compared with non-Hispanic whites. METHODS: Data from the 1992 US Natality File were used to calculate the percentage of MLBW and VLBW births among each Asian American and Pacific Islander subgroup. Logistic regression was used to calculate odds ratios (OR) after adjustment for maternal characteristics. RESULTS: VLBW OR ranged from 0.75 among Chinese to 1.59 among Asian Indians. MLBW OR ranged from 0.89 among Samoans to 2.12 among Asian Indians. Adjusted OR increased for most Asian American groups (e.g. VLBW OR = 1.89 for Asian Indians) and decreased among Pacific Islander subgroups, indicating relatively favourable risk characteristics for Asian Americans and unfavourable characteristics for Pacific Islanders. Risk of VLBW was not necessarily related to risk of MLBW. For instance, the VLBW OR among Japanese was 1.07, compared to an MLBW OR of 1.47. CONCLUSIONS: Marked heterogeneity in birthweight outcome was observed between Asian American and Pacific Islander subgroups. This heterogeneity was not related to traditional demographic risk factors. Additionally, risks of VLBW and MLBW were not always related. These findings suggests that the Asian American and Pacific Islander populations should not be aggregated into a single category, and that traditional measures of risk and birth outcome may not be valid for those groups.

Adolescent↗
PubMed2004

Microscopic anatomy of the lower eyelid in asians.

PURPOSE: To study the microscopic anatomic relation of the capsulopalpebral fascia, orbital septum, and tarsus of the lower eyelid in Asians. The anatomic differences between the Asian and non-Asian upper eyelid have been well described by various authors, but the differences of the lower eyelid have not been well characterized microscopically. The microscopic anatomy of the lower eyelid in non-Asians was well studied, but in Asians, despite the presence of gross differences, there were very limited studies on the microscopic anatomy. A thorough knowledge of the Asian lower eyelid anatomy is essential for surgical exploration of the eyelid. It may also explain the higher prevalence of eyelid disorders such as epiblepharon and entropion in Asians. METHODS: Ten normal Asian lower eyelids from 10 formalin-fixed cadavers (mean age, 67.5 years) were harvested and studied with light microscopy after staining with Masson trichrome. RESULTS: There was no fusion of the orbital septum and the capsulopalpebral fascia at the lower border of the tarsal plate in 7 specimens and a very limited fusion of these tissues in 3 specimens. The average distance from the inferior tarsal border to the first observable smooth muscle nuclei of the inferior retractors was 1.44 mm. The average tarsal plate thickness was 1.36 mm and the average tarsal plate height was 4.12 mm. CONCLUSIONS: The Asian lower eyelid anatomy differs from its non-Asian counterpart. There was no consistent fusion between the capsulopalpebral fascia and the orbital septum inferior to the inferior tarsal border. No extension of the capsulopalpebral fascia to the skin was observed. The average distance between the inferior retractors and the inferior tarsal plate was 1.44 mm in the normal Asian lower eyelid.

Aged↗
PubMed2003

Asian race and impact on outcomes after radical radiotherapy for localized prostate cancer.

PURPOSE: We compared survival outcomes in patients of Asian descent treated with curative intent radiation therapy for prostate cancer with that in the nonAsian population in British Columbia, Canada. MATERIALS AND METHODS: Since 1994, 1,872 men treated with curative intent radiotherapy for prostate cancer have been followed prospectively at our provincial institution, where cancer care delivery is coordinated for the province of British Columbia. Patients are treated uniformly based on provincial policies and guidelines. Patients were divided into 63 Asian (3.6%) and 1,804 nonAsian (96.4%) patients by surname with Asian names checked by telephone contact. Three risk groups were defined based on pretreatment prostate specific antigen, biopsy Gleason score and clinical T staging. For the whole cohort and each risk group survival was estimated using the Kaplan-Meier method and comparisons were made between the Asian and nonAsian populations. RESULTS: The mean age of Asian and nonAsian men was 71.5 and 71 years, respectively. Median prostate specific antigen was 11.4 and 10 ng/ml, respectively (p = 0.7). Median Gleason score was 7 for Asian patients and 6 for nonAsian patients (p = 0.002). There were twice the percentage of Asian patients with Gleason scores 8 or greater than nonAsian (26.5% vs 13.8%, p = 0.003). More Asian patients had stage 3 or 4 disease than nonAsian (44.8% vs 34.9%, p = 0.095). A greater proportion of Asian patients were classified as being at high risk than the nonAsian population (60.3% vs 47.6%, p = 0.04). For the entire cohort, and the low, intermediate and high risk groups there were no differences in time to first failure, or cause specific or overall survival for Asian vs nonAsian men. CONCLUSIONS: A greater proportion of patients of Asian descent present with high risk prostate cancer than nonAsian patients, which could be due to intrinsic biological differences and/or differences in diagnostic patterns. Survival outcomes after radiotherapy are the same for the 2 populations.

Aged↗
PubMed2005

Dry eye after LASIK: comparison of outcomes for Asian and Caucasian eyes.

BACKGROUND: Dry eye is a common complication of LASIK surgery. Our clinical impression was that post-LASIK dry eye was more problematic for our Asian patients. The aim of this study was to determine if dry eye after LASIK is more prevalent, more sustained and more severe in Asian eyes compared with Caucasian eyes. METHODS: This study was based on a retrospective analysis of a clinical database. Data (n = 932 eyes, 932 patients) was collected before and after (week 2 and months 1, 3 and 6) LASIK surgery. Patients were defined as Asian if both parents were of East Asian ethic origin. Assessments included dry eye symptoms, ocular surface staining, tear volume, tear secretion, tear film stability and corneal sensation. RESULTS: Asian eyes had greater ocular surface staining, poorer tear film stability and lower tear volume before LASIK and at all times after LASIK. Dry eye symptoms occurring 'often or constantly' were more prevalent at all time points after LASIK in Asian eyes. Chronic dry eye persisting six months or more after LASIK was diagnosed in 28 per cent of Asian eyes and 5 per cent of Caucasian eyes (p < 0.001). Asian patients with chronic dry eye were predominantly female, reported dry eye symptoms, had greater ocular surface staining and lower tear secretion, stability and volume before surgery. After LASIK, Asian eyes had a slower return to pre-operative values for ocular surface staining, tear volume and corneal sensation. DISCUSSION: The risk of chronic dry eye after LASIK was significantly higher in Asian eyes. Contributing factors could include racial differences in eyelid and orbital anatomy, tear film parameters and blinking dynamics and higher attempted refractive corrections in Asian eyes.

Adolescent↗
PubMed1990

Incidence of cancer in Bradford Asians.

STUDY OBJECTIVE: The aim of the study was to investigate the incidence of cancer in Asians living in Bradford. DESIGN: Cancer registrations were obtained from the Yorkshire Regional Cancer Registry for the six year period 1979-1984. Registrations relating to persons of Asian background were extracted using forenames and surnames. Data were analysed by disease category and age and sex specific incidence rates were calculated. These were compared with expected incidence rates for the non-Asian population and with rates for the Indian subcontinent derived from the Bombay Cancer Registry. SETTING: Data collection was confined to the Bradford Metropolitan District, population 449,897 (1981). SUBJECTS: The Asians studied originated from Pakistan (65%), India (28%), Bangladesh (4%), and East Africa (3%). The total Asian population of the Bradford Metropolitan District was approximately 45,000. MAIN RESULTS: Over the study period there were 178 Asian cancer registrations. The overall standardised registration ratio was 53.7 for males (100 cases, 95% confidence interval 43-64), and 43.5 for females (78 cases, 95% CI 34-53). The standardised registration ratios for cancer of the hypopharynx in males and gall bladder in females were significantly raised. There was a particularly low incidence of cancer of the stomach, large bowel, lung, skin, and bladder in males, and of skin, breast, cervix (in situ), and ovary in females. The analyses suggested that lung and breast cancer incidence may be increasing towards the non-Asian level. In situ cancer of cervix in Asians shows no evidence of the high rates found in younger non-Asian age groups. CONCLUSIONS: Lower incidence of many cancers in Asians may be due to lower exposure to major risk factors. Demographic change resulting in increased exposure to these risk factors can be expected to result in an increase in cancer incidence in Asians.

Age Factors↗
PubMed2002

Ethnic differences in total and HDL cholesterol concentrations: Caucasians compared with predominantly Punjabi Sikh Indo-Asians.

BACKGROUND: In comparison with Caucasians, Indo-Asians resident in the UK have similar total cholesterol but lower HDL cholesterol (HDLC) concentrations. It is however possible that cardiovascular risk factors may vary between culturally different Indo-Asians. METHODS: We present data on 223 Indo-Asians (129 men, 94 women) and 787 Caucasians (421 men, 366 women) in whom a laboratory-based coronary heart disease (CHD) risk score calculation had been requested. RESULTS: Total cholesterol concentrations were similar in Indo-Asians and Caucasians. HDLC concentrations were higher (P < 0.001) in Caucasians [1.4 (1.3-1.4) mmol/L; median (95% confidence intervals)] than in Indo-Asians [1.2 (1.2-1.3) mmol/L]. Indo-Asian women [1.2 (1.2-1.3) mmol/L], Indo-Asian men [1.2 (1.2-1.3) mmol/L] and Caucasian men [1.2 (1.2-1.3) mmol/L] had similar HDLC concentrations but these were all lower (P < 0.001) than those in Caucasian women [1.4 (1.3-1.4) mmol/L]. CONCLUSION: We confirm low HDLC concentrations in Indo-Asians, but propose that this is solely due to low HDLC concentrations in Indo-Asian women. Since Indo-Asians in Wolverhampton are predominantly Punjabi Sikhs, we suggest that the difference between this study and previous reports may be due to heterogeneity of CHD risk factors within culturally diverse Indo-Asians.

Adult↗
PubMed2006

Periodontal diseases in Asians.

Asia encompasses three of the four most populous nations in the world (China, India and Indonesia), accounting for nearly two-fifths of the worlds' total population. Over half of the world's population now inhabits Asia, which by definition includes countries of the Middle East and some former Socialist Soviet Republics. There has been a generally held view that Asians are particularly susceptible to periodontitis. The aim of this review is to consider the reasons for this view having become entrenched and to examine the evidence on which it could have been established and sustained. This view of a particularly high prevalence of periodontal diseases in Asians appears in retrospect to have originated from early epidemiological studies using an index system which gives weight to gingivitis and moderate periodontitis resulting from poor oral hygiene and calculus deposition, very commonly encountered in Asian populations. Studies that have been conducted comparing Asians immigrants with native Caucasians in industrialized northern hemisphere nations broadly concluded that Asians displayed worse periodontal conditions than Caucasians. Similarly, a classic study comparing Norwegian males with Sri Lankan Tamil males demonstrated worse periodontal conditions in the Asian males. A recent review (Albander and Rams, 2002) has stated that those of African origin display the highest prevalence of periodontitis followed by Hispanics and Asians. Studies of the natural history of periodontal disease in Asians, of perio-dontopathogens in Asians, of risk for periodontal destruction, and of reasons for extraction do not appear to explain increased susceptibility of Asians to periodontal destruction. Poor oral hygiene and calculus deposits are widespread, however. Traditional assessments of periodontitis focus on destruction of the periodontal attachment in terms of attachment loss and probing pocket depths, with no consideration being given to the morphological features of the dentition from which the periodontal attachment is being lost, features that may predispose to or complicate the management of periodontal destruction. The Mongoloid dentition shows a high prevalence of such features, which adds a further dimension to the consideration of periodontal diseases among many Asian peoples. Appropriate strategies for the prevention and management of periodontal disease should focus upon improvements in the oral hygiene situation in the diverse continent of Asia.

Asian People↗
PubMedDate not supplied

A portrait of Asians and Pacific Islanders in the United States.

Asians and Pacific Islanders (API) have an increasingly visible presence in the United States. This diverse population--encompassing persons with ancestry from East and Southeast Asia, the Indian subcontinent, and the Pacific islands--has grown at a faster rate than any other major racial or ethnic group. In 1996 Asian Americans numbered approximately 9.7 million (up from 3.8 million in 1980), nearly 4 percent of the U.S. population. The Census Bureau projects that this population group will reach 34.4 million by 2050, representing roughly 9 percent of all Americans. While immigration has fueled much of this growth, Asians' young age structure also will help boost their numbers in the next century. Fifty-six percent of Asian Americans live in three states--California, New York and Hawaii. Asian Americans comprise very small proportions of the populations of most other states. About 77 percent of the 2.8 million API households in 1996 were families, compared with 69 percent of white households. Roughly one in six Asian American households has five or more persons, compared with one in 12 white households. Educationally, Asians tend to be high achievers--42 percent of all API adults have at least a bachelor's degree, compared with 26 percent of while adults. Two-thirds of Asian Americans participated in the civilian labor force in 1996. Among employed Asians, one-third held managerial and professional jobs. Both proportions were roughly the same as for whites. Although the median income for API households was 9 percent higher than for white households in 1995, this difference is largely due to Asian households having more workers contributing to the household income. Despite these apparent measures of success, the poverty rates for Asian American families and individuals are nearly twice as high as those for whites.

Adult↗
PubMed1998

The Asian lower eyelid: a comparative anatomic study using high-resolution magnetic resonance imaging.

Asian upper and lower eyelids are typically characterized by a fuller appearance than the lids of whites. Inferior extension of preaponeurotic fat and brow fat into the Asian upper lid explain the upper lid fullness and its difference from the upper lid of whites. Analogous structures in the Asian lower lid may exist to explain its full appearance. High-resolution magnetic resonance imaging (MRI) of 24 normal Asian and white lower lids was performed to evaluate differences in Asian and white lower lid anatomy. Magnetic resonance images revealed two major differences. First, the orbital fat projected further anteriorly with respect to the orbital rim in all Asian lower lids studied. No analogy with the upper lid exists for this difference. Second, the orbital fat extended further superiorly, to the inferior border of tarsus, in those Asian lower lids that did not have well defined creases. This was analogous to the preaponeurotic fat location of the Asian upper lid and different from the white lower lid. The suborbicularis oculi fat in the lower lid, the analogous structure of the brow fat pad in the upper lid, was not different in location in Asian and white lower lids. Therefore, the Asian lower lid appearance is explained by the difference in orbital fat location, which is only partly analogous to the anatomical differences between the Asian and white upper lids.

Adipose Tissue↗
PubMed1979

The molecular basis of alpha-thalassemias: frequent occurrence of dysfunctional alpha loci among non-Asians with Hb H disease.

Study of Asians has previously indicated that deletion of alpha-globin structural genes is the predominant lesion in alpha-thalassemias and that Hb H disease occurs when three of four normal alpha loci per cell are deleted. To test the generality of this model, Hb H disease DNAs of both Asian and non-Asian origin were analyzed by restriction endonuclease mapping using the technique of Southern (1975). Whereas in normal DNA, alpha sequences are present in a single Eco Rl fragment of cellular DNA approximately 22.5 kb long, fragments of 22.5, 20 and 2.6 kb were found in various Hb H disease DNAs. The 20 kb Eco Rl fragment alone, in which a single alpha-globin structural locus resides, was found in Asian Hb H disease DNA. This finding is consistent with the deletion model of alpha-thalassemia. In contrast, seven of eight non-Asian Hb H disease DNAs displayed a more complex molecular composition. The fragment patterns observed were 22.5 kb alone, 22.5 plus 2.6 kb, 20 plus 2.6 kb and 20 kb alone. Non-Asian Hb H disease DNAs contained one, two or three alpha loci per cell in contrast to the one locus predicted by the simple deletion model of alpha-thalassemia. The data are best explained by the existence of defective alpha loci in certain individuals with alpha-thalassemia, particularly outside the Asian population. Restriction mapping of the 20 kb Eco Rl fragment found in Asian and some non-Asian Hb H disease DNAs demonstrated a striking similarity in the placement of restriction sites about the single alpha gene compared with sites about the two genes in the 22.5 kb Eco Rl fragment seen in normal DNA. These data are consistent with origin of the 20 kb fragment from the 22.5 kb normal Eco Rl fragment by either unequal crossing-over or a deletion event. The molecular heterogeneity and frequent occurrence of defective alpha loci in non-Asian Hb H disease DNAs described here may explain, in part, the clinical heterogeneity of alpha-thalassemias and the absence of the homozygous deletion state (hydrops fetalis) in non-Asians. Further study of cellular DNA fragments containing the defective alpha loci identified in this work may indicate the types of specific mutations responsible for abnormal globin gene expression and complement similar studies on abnormal beta genes in beta-thalassemias.

Asia↗