Biomedical subjects

D B Kubrusly

Publications and source records attributed to D B Kubrusly.

6 recordsLinked to original sources

PubMed1993

An ultrasound survey of gallbladder disease among Mexican Americans in Starr County, Texas: frequencies and risk factors.

The Mexican-American population of south Texas has been shown previously to have elevated frequencies of gallbladder disease, based on medical history. In the present study, ultrasonography was employed to screen 1004 randomly selected individuals aged 15 to 74 years. Among women, the frequency of previous cholecystectomy was 10.0%; the frequency of stones on ultrasound was 12.2%. In men, the respective frequencies were 1.7% and 6.3%. Highest frequencies of gallbladder disease occurred among those aged 45 years or above: 40.2% and 19.2% among women and men, respectively. Non-insulin-dependent diabetes mellitus, obesity, and hypertension were also markedly elevated in this population. Overall, more than 40% of the population had either gallbladder disease, non-insulin-dependent diabetes, obesity, or hypertension. Among those older than 45 years, 70% had one or more of these chronic conditions. Examining the associations of gallbladder disease with other chronic diseases or measures of lipids, lipoproteins, and apolipoproteins demonstrates that factors predictive of or associated with cholecystectomy are different from those for gallstones by ultrasound. Diabetes and obesity show the strongest associations with cholecystectomy among women under 45 years (women with diabetes being 6.8 times as likely to have had a cholecystectomy than those without diabetes). Testing an extensive array of lipid-related measures resulted in no clear patterns, with the possible exception of alpha-lipoprotein and related measures. That the Mexican-American population is relatively young and experiencing extremely rapid growth indicates that the burden of chronic disease in general and gallbladder disease in particular will increase dramatically in the coming years.

Adolescent↗

PubMed1986

Blood pressure, insulin, and glycemia in nondiabetic subjects.

The relation of blood pressure to fasting (basal) insulin and glycosylated hemoglobin (hemoglobin A1) was examined in 248 nondiabetic subjects (137 women and 111 men). None of the subjects was taking antihypertensive medication. There were statistically significant associations of systolic and diastolic blood pressure with insulin levels (r = 0.24, p less than 0.01; r = 0.30, p less than 0.01) and hemoglobin A1 levels (r = 0.28, p less than 0.001; r = 0.22, p less than 0.05) in women. These blood pressure indexes were also related to insulin levels in men (r = 0.23, p less than 0.05; r = 0.02, p less than 0.05). In a multiple regression analysis, the association between blood pressure and insulin level was diminished with an allowance for adiposity; however, it remained statistically significant. These data indicate that blood pressure is related to insulin levels in nondiabetic subjects and suggest that insulin may be a physiologic determinant of blood pressure.

Blood Glucose↗

PubMed1986

High-density lipoprotein and glycosylated hemoglobin in nondiabetic individuals.

We investigated associations of high-density-lipoprotein (HDL) cholesterol, apolipoprotein A-I, and triglyceride levels with hemoglobin A1 (HbA1) and insulin levels in nondiabetic subjects (137 women and 111 men). In women, HDL cholesterol, apolipoprotein A-I, and log-triglyceride values were significantly correlated with those of HbA1 and log-fasting insulin. These univariate associations persisted when age and Quetelet's index were included as covariates in multiple regression analyses. Conversely, univariate associations of HDL cholesterol and log-triglyceride levels with Quetelet's index were diminished by the addition of insulin values to multivariate models. Insulin levels and Quetelet's index were highly correlated. Although there were weaker associations in men, apolipoprotein A-I and HbA1 values were inversely related. These data suggest that HDL cholesterol and apolipoprotein A-I levels are closely linked to glucose metabolism in nondiabetic individuals.

Adult↗

PubMed1985

Systemic necrotizing vasculitis seen initially as hypertensive crisis.

Necrotizing vasculitis is not usually considered in the differential diagnosis of hypertensive crisis. Three cases are presented in which hypertensive crisis with encephalopathy was the principal initially seen manifestation of systemic necrotizing vasculitis. The correct diagnosis was suspected because of the patients' young age, elevated ESRs, and evidence of previous exposure to hepatitis B virus and was confirmed by renal angiography. All three patients had metabolic alkalosis, and two of the three patients had hyponatremia and hypokalemia. The literature presents a picture of hypertension in necrotizing vasculitis as insidious, relentless, and progressive. Our cases illustrate that it can be a dramatic, life-threatening initial manifestation. A renal angiogram can be justified in similar patients, since effective therapy for necrotizing vasculitis exists. In these patients control of BP ultimately depends on successful treatment of the underlying vasculitis.

Adult↗

PubMedDate not supplied

Impaired vibratory perception and diabetic foot ulceration.

We have studied risk factors for diabetic foot ulceration by comparing diabetic patients who had active foot ulcers (n = 86) with diabetic patients who had no history of foot ulcers (n = 49). Whereas there was a strong association of diabetic foot ulceration with abnormal vibratory perception (Odds Ratio = 10.77; p less than 0.001, which increased with worsening vibratory perception), there was little association with abnormality of the ankle-pressure index (Odds Ratio = 2.84, p = n.s.). Although foot ulceration and limited joint mobility were associated (Odds Ratio = 3.57, p less than 0.001), this relation was not significant when allowances for abnormal vibratory perception and diabetes duration were made. These data suggest that sensory neuropathy is of greater aetiological importance than peripheral vascular disease in the development of diabetic foot ulceration. The measurement of the vibratory perception threshold is clinically useful in identifying those diabetic patients at high risk of foot ulceration.

Diabetes Complications↗

PubMedDate not supplied

The vibratory perception threshold in young diabetic patients: associations with glycemia and puberty.

The vibratory perception threshold, an indicator of sensory neuropathy, was measured in young type I diabetic patients (N = 55) and nondiabetic control subjects (N = 34) of similar age. Values were significantly higher in the diabetic patients (P less than 0.01), and 20% had values greater than that of any control subject. This difference was most marked among those postpubertal and persisted with allowances for age and gender in an analysis of covariance. Although the vibratory perception threshold was not related to hemoglobin A1 in younger diabetic patients (Tanner stage less than 5), there was a highly significant positive relationship in postpubertal patients (r = 0.72, P less than 0.001). There were also associations of the vibratory perception threshold with age in diabetic and control subjects (r = 0.44 and r = 0.43, respectively, P less than 0.01 for both) and with diabetes duration (r = 0.36, P less than 0.01). These data indicate that vibratory perception threshold abnormalities occur early in the course of type I diabetes mellitus; however, they are more evident in those patients who are postpubertal. In addition, they suggest that the association between the vibratory perception threshold and glycemia may be modified by developmental factors.

Adolescent↗