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Biomedical subjects

B B Duncan

Publications and source records attributed to B B Duncan.

46 records · Page 3Linked to original sources
PubMed1992

Association of waist-hip ratio with diabetes mellitus. Strength and possible modifiers.

OBJECTIVE: To characterize the association between central obesity, as measured by the waist-hip ratio (WHR), and non-insulin-dependent diabetes mellitus (NIDDM), considering the effects of sex, age, overall obesity, and family history of diabetes. RESEARCH DESIGN AND METHODS: Case-control study nested within a community-based survey. We selected 151 subjects with NIDDM and 301 nondiabetic control subjects as a systematic sample of survey screening negative individuals. RESULTS: Odds ratios for NIDDM, comparing a high WHR (greater than or equal to 0.926 for men, greater than or equal to 0.83 for women) to a low WHR were 4.72 with a 95% confidence interval of 2.39-9.34, and 2.17 with a 95% confidence interval of 1.03-4.58, for women and men, respectively, controlling for age, overall obesity, and a family history of diabetes. Women with high WHRs in the presence of these risk factors are notably at risk for diabetes. CONCLUSION: Central obesity, as measured by the WHR, is importantly and independently associated with NIDDM.

Adult↗
PubMed1984

Nonenzymatic glycosylation of proteins--a new tool for assessment of cumulative hyperglycemia in epidemiologic studies, past and future.

In conclusion, the discovery of nonenzymatic glycosylation of proteins has opened new horizons in all aspects of diabetes management and research. The field is young. Advances in the understanding of the role of this phenomenon in the pathogenesis of diabetic complications and in the quantitating of its occurrence in various bodily proteins, come monthly. The nonenzymatically glycosylated protein markers, because they offer increased internal validity and precision, afford significant advantages over the classical measures of hyperglycemia. By providing improved means of assessing cumulative hyperglycemia, they will contribute to a better understanding of the relationship of diabetes to its chronic complications. They may also lead to an appreciation that mild hyperglycemia plays a substantial causal role in diseases, such as cardiovascular, with which diabetes has been traditionally associated. A variety of nonenzymatically glycosylated proteins exist, applicable to different purposes. Stored sera may well allow their retrospective determination in studies conceived of and/or executed without an appreciation of their potential. It behooves epidemiologists interested in any aspect of diabetes or in diseases for which diabetes is a relevant study factor, to become familiar with the process, measurement, and potential value of nonenzymatic glycosylation of proteins.

Blood Glucose↗
PubMed1984

Effect of premedication on the induction dose of thiopentone in children.

The effective dose of thiopentone in 90% ( ED90 ) of unpremedicated children is 10.5 mg/kg. This is significantly greater (p less than 0.01) than in premedicated children. The ED90 in children premedicated with TDP (a mixture of trimeprazine , droperidol and physeptone with atropine) is 4.2 mg/kg which is significantly less (p less than 0.05) than with trimeprazine and atropine ( ED90 5.2 mg/kg) or papaveretum and hyoscine ( ED90 5.0 mg/kg).

Anesthesia, Intravenous↗
PubMedDate not supplied

[Evidence-based medicine].

The growing array of diagnostic and therapeutic options available to the clinician has created the necessity of techniques, such as the randomized clinical trial, to evaluate their effectiveness. Recently, with the increasing penetration of the methods of clinical epidemiology into medical practice, the concept of an evidence-based medicine has arisen. Emphasizing the necessity of solid clinical evidence for clinical decision-making, evidence-based medicine provides a framework for the integration of research results into clinical practice. The evidence is graded, principally on the basis of study design, and norms are established as to what constitutes adequate evidence for clinical decision-making. The combination of this new paradigm of medical practice with the power of modern telecommunications is causing a revolution in the way medicine is practiced. Its integration into clinical practice is being facilitated by quantitative overviews of the literature, and the creation of clinical guidelines based on these reviews. Shortcomings of the traditional sources of evidence have been documented. New sources of evidence, such as the ACP Journal Club, and the Cochrane Collaboration, diminish dramatically the time required of clinicians to obtain the best available evidence. All health professionals should familiarize themselves with evidence-based medicine.

Databases, Bibliographic↗
PubMedDate not supplied

Frequency of early-morning rise in blood glucose in children with diabetes at camp.

To estimate the frequency of an early-morning glucose rise (EMR) in relatively unselected children with insulin-dependent diabetes mellitus (IDDM), we assessed capillary blood glucose (CBG) at midsleep (0200-0430) and prebreakfast (0700-0800) in 97 children with diabetes at camp. The EMR (prebreakfast CBG-midsleep CGB) was inversely related to the midsleep CBG level (r = -.45, P less than .001). Of the 49 children with midsleep CBG less than 200 mg/dl, the mean EMR was 34 +/- 60 mg/dl, and 18 of these children had rises of greater than 40 mg/dl. In conclusion, when midsleep glycemia is less than 200 mg/dl, a rise in blood glucose from midsleep to prebreakfast, often greater than 40 mg/dl, is a common element of glycemic control among children with IDDM. The relative importance of the Somogyi phenomenon, the dawn phenomenon, and mere insulin insufficiency in the early-morning hours cannot be determined from these data.

Adolescent↗
PubMedDate not supplied

The flashlight test lacks validity as a screen for nocturnal hypoglycemia.

Though never validated, the flashlight test is a commonly used screen for nocturnal hypoglycemia. Between 2 a.m. and 4 a.m., we applied the test to 107 children at Eagle's Nest Camp for Children with Diabetes. We validated the test against simultaneously determined capillary blood glucose values (Glucoscan). An eyelid squint in response to the flashlight was considered an intact test. No significant difference existed between mean glucoses for intact and nonintact responses. Both sensitivity and positive predictive value are too low for the flashlight test to be useful in screening for nocturnal hypoglycemia.

Adolescent↗
PubMedDate not supplied

Tendencies in adult mortality in Rio Grande do Sul, Brazil, 1970-1985. An international comparison.

"In order to evaluate mortality trends in adults aged 30-69 years in the State of Rio Grande do Sul [Brazil], changes in age-standardized mortality from 1970 to 1985 were calculated and compared with trends of 33 other countries. Virtual stability in Rio Grande do Sul over this 16-year period contrasts with dramatic reduction in age-standardized all-cause and cardiovascular disease mortality in many countries.... The data demonstrate that major declines in adult mortality can be achieved, and suggest that, during the period 1970-1985, Rio Grande do Sul participated little in the international tendency toward improved adult health." (SUMMARY IN POR)

Age Factors↗
PubMedDate not supplied

[High mortality rates among Brazilian adult populations--an international comparison].

Adult disease in an increasingly important public health problem in Brazil. In order to compare adult mortality in Brazil to that in other countries, age-adjusted coefficients for adults aged 30-69 of the States of São Paulo and Rio Grande do Sul and of the city of Fortaleza (Ceará State) are compared to those of similarly aged adults in a series of 33, principally European, countries. The Brazilian population coefficients for overall, cerebrovascular and cardiovascular mortality are among the highest of the series; those for ischemic heart disease occupy median positions. These comparisons illustrate the precarious state of adult health in Brazil and, given the growing possibilities of preventing cardiovascular and other non-communicable diseases, help demonstrate the need for preventive programs in Brazil aimed at the major common and lethal diseases of the productive years of life.

Adult↗
PubMedDate not supplied

[Smoking in Porto Alegre: prevalence and the role of health professionals in its prevention].

This study was undertaken in 1988 in order to evaluate the prevalence of smoking, the degree of awareness of smokers and ex-smokers to risks of smoking, and the role of health professionals in the control of smoking in Porto Alegre. A total of 407 persons between 15 and 64 years were interviewed in a population-based survey. Of these, 170 (41.8%) smoked. Among ex-smokers, 85.7% stopped due to awareness of the harm that cigarettes can cause. Only 16.5% of smokers and ex-smokers were warned to the risks of smoking by health professionals before acquiring the habit. After becoming smokers, only 51.4% were warned. These indices are a cause for concern as we believe that prevention is the best approach to control of the smoking epidemic.

Adolescent↗