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Biomedical subjects

J M Newman

Publications and source records attributed to J M Newman.

34 records · Page 2Linked to original sources
PubMed1994

Angiotensin II: endothelium-derived nitric oxide interaction in conscious rats.

In anesthetized rats, renal perfusion is largely regulated by a balance between the vasodilator influence of endothelium-derived nitric oxide (EDNO) and angiotensin II (AII)-mediated vasoconstriction. However, in conscious rats, which are characterized by lower PRA, the influence of AII is largely dissipated. To determine whether chronically increasing PRA enhances the interaction between AII and EDNO in regulating renal perfusion, radioactive microspheres were used to assess RBF in conscious sodium-depleted rats. PRA of control rats on a standard diet was 2.3 +/- 0.3 ng of AI/mL per hour compared with 16.8 +/- 1.5 ng of AI/mL per hour (P < 0.001) for rats on a sodium-restricted diet. In 12 rats on a standard diet, the inhibition of EDNO synthesis with L-Nw-nitroarginine methyl ester (L-NAME) increased blood pressure (BP) from 111 +/- 2 to 135 +/- 3 (P < 0.001) and decreased RBF by 47% (from 8.0 +/- 0.6 to 4.3 +/- 0.3 mL/min per gram kidney wt; P < 0.001). Renal vascular resistance (RVR) increased by 132% (from 14.9 +/- 1.2 to 34.7 +/- 3.3 resistance units (RU); P < 0.001). Pretreatment with Losartan, an AII receptor antagonist, did not modify the changes in BP, RBF, and RVR induced by L-NAME.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗
PubMed1993

Surveillance for diabetes mellitus--United States, 1980-1989.

PROBLEM/CONDITION: In the United States, diabetes mellitus is the most important cause of lower-extremity amputation and end-stage renal disease; the major cause of blindness among working-age adults; a major cause of disability, premature mortality, congenital malformations, perinatal mortality, and health-care costs; and an important risk factor for the development of many other acute and chronic conditions (e.g., diabetic ketoacidosis, ischemic heart disease, stroke). Surveillance data describing diabetes and its complications are critical to increasing recognition of the public health burden of diabetes, formulating health-care policy, identifying high-risk groups, developing strategies to reduce the burden of this disease, and evaluating progress in disease prevention and control. REPORTING PERIOD COVERED: In this report, data are summarized from CDC's diabetes surveillance system; trends in diabetes and its complications are evaluated by age, sex, and race for the years 1980-1989. DESCRIPTION OF SYSTEM: CDC has established an ongoing and evolving surveillance system to analyze and compile periodic, representative data on the disease burden of diabetes and its complications in the United States. Data sources currently include vital statistics, the National Health Interview Survey, the National Hospital Discharge Survey, and Medicare claims data for end-stage renal disease. RESULTS AND INTERPRETATION: In 1989, approximately 6.7 million persons in the United States reported that they had diabetes mellitus, and a similar number probably had this disabling chronic disease without being aware of it. The disease burden of diabetes and its complications is large and is likely to increase as the population grows older. Effective primary, secondary, and tertiary prevention strategies are needed, and these efforts need to be intensified among groups at highest risk, including blacks. Important gaps exist in periodic and representative data for describing the disease burden. ACTIONS TAKEN: CDC is assisting diabetes control programs in 26 states and one territory. These programs attempt to reduce the burden of diabetes by preventing blindness, lower-extremity amputations, cardiovascular disease, and adverse outcomes of pregnancy among persons with diabetes. Because of important limitations in measuring the burden of diabetes, CDC is exploring sources of surveillance data for blindness, adverse outcomes of pregnancy, and the public health burden of diabetes among minority groups.

Adult↗
PubMed1993

Diabetes-associated mortality in Native Americans.

OBJECTIVE: To describe diabetes-associated mortality among Native Americans. RESEARCH DESIGN AND METHODS: In this population-based study, we analyzed diabetes-associated mortality data from the IHS and the NCHS. We also examined diabetes data from the 1986 NMFS. RESULTS: IHS area-specific diabetes mortality rates for 1984-1986 ranged from 10 to 93/100,000, compared with 15/100,000 for the total U.S. population. NCHS data for the same period listed diabetes as the underlying cause of 708 deaths among Native Americans and the contributory cause of 1252 deaths; 63% of the latter deaths were attributable to circulatory diseases. The 1986 NMFS demonstrated that Native American heritage is underreported by 65% on death certificates. Using deaths identified as Native American by NMFS, the age-adjusted mortality rate for diabetes as the underlying cause for Native Americans (96/100,000) was 4.3 times that for whites and two times that for blacks. Where diabetes was a contributory cause of death, the mortality rate for Native Americans (264/100,000) was 3.7 times that for whites and 2.4 times that for blacks. CONCLUSIONS: The excessive diabetes-associated mortality among Native Americans is consistent with other indicators of the magnitude of the diabetes problem in this population. Further epidemiological research and expanded diabetes control interventions are needed.

Age Factors↗
PubMed1993

Survey of physician practice behaviors related to diabetes mellitus in the U.S. Physician adherence to consensus recommendations.

OBJECTIVE: To summarize the frequency of physician adherence to consensus recommendations for prevention of diabetic complications. RESEARCH DESIGN AND METHODS: Survey data from a nationwide stratified probability sample of primary-care physicians were analyzed. Adherence to recommendations were reported by physician specialty, age-group, and type of diabetes treated. RESULTS: Adherence was high for eye exams, blood pressure measurements, neurological and circulatory exams, and laboratory procedures using blood. Adherence was low for examination of the teeth and gums, examination of the feet, and laboratory procedures involving the collection of urine. Internists generally had the highest adherence rates and pediatricians the lowest. Reported adherence decreased with physician age. Adherence was higher for the management of individuals with IDDM than for those with NIDDM. CONCLUSIONS: Recommendations for the care of diabetic individuals need to be more widely implemented. Recommendations targeted specifically to pediatricians may be necessary.

Adult↗
PubMed1993

Alternative approaches to public health surveillance of IDDM.

OBJECTIVE: To assess the appropriateness of national surveillance of IDDM. RESEARCH DESIGN AND METHODS: We reviewed the structure and function of national disease surveillance, the diverse goals of IDDM surveillance, and prior experience with IDDM as a reportable disease. RESULTS: Surveillance is the systematic and ongoing collection, analysis, interpretation, and dissemination of data linked to public health action. The potential goals of surveillance of IDDM are to understand the etiology and trends in incidence of IDDM, to measure the burden of IDDM and its complications, and to assess mortality. Problems associated with surveillance of IDDM include underreporting, delayed reporting, and lack of funding. CONCLUSIONS: To make IDDM a nationally reportable disease is neither warranted nor feasible at this time. Although surveillance is needed to understand diabetes better and for diabetes control, proposed initiatives, such as major expansions of IDDM reporting, should be developed to address specific questions, problems, and needs--still recognizing real-world issues of competing priorities and limited resources.

Centers for Disease Control and Prevention, U.S.↗
PubMed1992

Trends in diabetes and diabetic complications, 1980-1987.

OBJECTIVE: Although diabetes is a major source of morbidity and mortality in the United States, only recently has a unified national surveillance system begun to monitor trends in diabetes and diabetic complications. RESEARCH DESIGN AND METHODS: We established a diabetes surveillance system using data for 1980-1987 from vital records, the National Health Interview Survey, the National Hospital Discharge Survey, and the Health Care Financing Administration's records to examine trends in the prevalence and incidence of diabetes, diabetes mortality, hospitalizations, and diabetic complications. RESULTS: From 1980 through 1987, the number of individuals known to have diabetes increased by 1 million--to 6.82 million. Age-standardized prevalence for diabetes increased 9% during this period, from 25.4 to 27.6/1000 U.S. residents (P = 0.03). The incidence of diabetes increased among women (P = 0.003), particularly among those greater than 65 yr old (P = 0.02). Age-standardized mortality rates (for diabetes as either an underlying or contributing cause) per 100,000 individuals with diabetes declined 12%, from 2350 to 2066. Annual mortality rates from stroke (as an underlying cause and diabetes as a contributing cause) and diabetic ketoacidosis declined 29% (P = 0.003) and 22% (P less than 0.001), respectively. During these 8 yr, hospitalization rates for major CVD and stroke (as the primary diagnoses and diabetes as a secondary diagnosis) increased 34% (P = 0.006) and 38% (P = 0.01), respectively. Also during this period, hospitalization rates increased 21% for diabetic ketoacidosis (P = 0.01) and 29% for lower-extremity amputations (P = 0.06). From 1982 through 1986, treatment for end-stage renal disease related to diabetes increased greater than 10% each year (P less than 0.001). The prevalence of diagnosed diabetes was nearly twice as high in blacks as in whites (P = 0.04). Blacks also had increased rates of lower-extremity amputation (P = 0.02), diabetic ketoacidosis (P less than 0.001), and end-stage renal disease (P = 0.01). CONCLUSIONS: Diabetes surveillance data will be useful in planning, targeting, and evaluating public health efforts designed to prevent and control diabetes and its complications.

Amputation, Surgical↗
PubMed1990

End state renal disease among Native Americans, 1983-86.

We used data reported to Medicare from 1983 through 1986 to determine the incidence of end-stage renal disease (ESRD) among Native Americans and Whites in the United States. The 1,075 Native American cases represented an annual incidence, age-adjusted to the White population, of 269 per million, 2.8 times the rate for Whites. Fifty-six percent of Native American cases and 27 percent of the White cases were attributed to diabetes, indicating that ESRD is a major problem. Diabetes control provides the greatest opportunity for prevention.

Adolescent↗
PubMed1989

Blood-building foods in contemporary Chinese populations.

According to ancient Chinese medicine, "weak blood" is a yin condition that occurs during growth, pregnancy, the postpartum period, and old age. Treatment requires use of special foods that are "yang" in nature. This article investigated the use of such blood-building foods in seven contemporary Chinese populations throughout the world. Analysis of questionnaires from 379 respondents indicated that high-protein foods, such as pork liver and other meats, were recommended most often. Although these and other foods recommended were primarily yang, only 8.1% of respondents considered weak blood a "yin" condition. Comparison of 717 responses concerning foods that should be used to treat weak blood showed more similarities than differences between Chinese populations in different parts of the world. Strong adherence to cultural practices was also evident. Self-diagnosis and self-prescription are common modes of treating symptoms in the Chinese and other cultures. Knowledge of beneficial food-related health practices can enable practitioners to counsel their clients more effectively and to develop bilingual educational materials that incorporate familiar cultural practices.

Aging↗
PubMed1988

Incidence of end-stage renal disease in type 2 (non-insulin-dependent) diabetes mellitus in Pima Indians.

The incidence of end-stage renal disease was determined in the Pima Indians of the Gila River Indian Community in Arizona, a population with a high prevalence of Type 2 (non-insulin-dependent) diabetes mellitus. Between 1975 and 1986, from a study population of 5059 subjects, end-stage renal disease occurred in 80 persons, 76 (95%) of whom had Type 2 diabetes. A review of the cases with end-stage renal disease indicated that among the diabetic subjects only two cases could be attributed to nondiabetic renal disease; all other cases were attributable to diabetic nephropathy. In diabetic Pima Indians the incidence rate of end-stage renal disease did not change during the study period, was similar in men and women, and was not effected by age at diagnosis of diabetes or by attained age, but did increase significantly with hypertension (p less than 0.05). The incidence of end-stage renal disease attributed to diabetic nephropathy increased from 0 cases/1000 person-years at 0-5 years to 40.8 cases/1000 person-years at greater than or equal to 20 years duration of diabetes. In these subjects with Type 2 diabetes, the incidence rate of end-stage renal disease was similar to that in subjects with Type 1 (insulin-dependent) diabetes who were followed at the Joslin Clinic in Boston, Massachusetts when those with similar duration of diabetes were compared.

Age Factors↗
PubMed1984

A study of neonates' differential responses to three voices, as measured by transcutaneous oxymonitor.

123 newborn infants were tested for changes in arterial oxygen status as an index of response to three voices, one of these being the maternal voice. Male infants responded more than female infants to their mother's voice, but female infants showed a higher response to the other female voice and the male voice. Black infants of each sex responded more than white infants to the maternal voice and to the other female voice. White female infants responded more than black female infants to the male voice.

Black or African American↗
PubMed1984

Occult sternal metastasis identified by laminography in patients with chest pain.

Six patients with occult sternal metastasis presenting with chest pain, and four with sternal deformity associated with "arthritis" had undergone routine roentgenographic examinations, reported as "normal." Subsequent laminography of the sternum demonstrated lytic lesions confirmed by needle biopsy. Adenocarcinoma of the lung and breast were identified in two each of four patients; myeloma and kidney neoplasms were the primary source of malignancy in the remaining two patients. In widespread malignancy, metastasis to the skeletal chest wall is a well-recognized occurrence. Infrequently, it can be an isolated manifestation of an occult or recurrent malignancy, initially overlooked when routine roentgenograms are read as normal. Although sternal x-rays remain the most important means of diagnosis, in suspected cases of sternal metastasis laminography alone may initially reveal lytic lesions.

Adult↗
PubMedDate not supplied

The disease-specific benefits and risks of physical activity and exercise.

Physical inactivity has been related to the occurrence of coronary heart disease, hypertension, diabetes mellitus, and osteoporosis. The literature was reviewed to determine what is and what is not known about the efficacy and safety of physical activity in each of these conditions. Although there is a transient increase in the risk of sudden cardiac death during vigorous activity, there is mounting evidence that habitual vigorous activity is associated with an overall reduced risk of coronary heart disease. It is unlikely that this association merely reflects the "selection" that results from sick persons who tend to be less active. Several studies suggest that physical activity may be related to the prevention and control of hypertension, diabetes mellitus, and osteoporosis. However, additional research is needed to make explicit the risks and benefits of physical activity in each of these conditions. Finally, future efforts should determine the type, intensity, frequency, and duration of activity required to maximize the benefits and minimize the hazards of physical activity. The public health and clinical significance of these questions requires that they be examined in the most rigorous manner feasible.

Coronary Disease↗