PubMed Health⌕ Search

Biomedical subjects

S E Moss

Publications and source records attributed to S E Moss.

At least 19 recordsLinked to original sources
PubMed1996

The incidence of hypertension in insulin-dependent diabetes.

BACKGROUND: There are few epidemiologic data describing the long-term incidence of hypertension in people with diabetes. METHODS: In a population-based study performed in southern Wisconsin, 765 individuals diagnosed as having diabetes when they were younger than 30 years and taking insulin participated in baseline, 4-year, and 10-year examinations. Blood pressure was measured by standardized protocols,and hypertension was defined as a mean systolic blood pressure of 160 mm Hg or more ( > or = 140 mm Hg in those younger than 25 years) and/or mean diastolic blood pressure of 95 mm Hg or more ( > or = 90 mm Hg in those younger than 25 years) and/or history of hypertension with the use of antihypertensive medication. RESULTS: The prevalence of hypertension at baseline was 17.3%. The 10-year incidence of hypertension was 25.9%. The incidence of hypertension was greater with older age, longer duration of diabetes, higher glycosylated hemoglobin level, proteinuria, more severe retinopathy, and male gender. After other risk factors were controlled for, the 10-year incidence of hypertension was significantly related to higher glycosylated hemoglobin level (odds ratio, 1.23 per percentage increase; 95% confidence interval, 1.13 to 1.34) presence of gross proteinuria (odds ratio, 3.64; 95% confidence interval, 2.26 to 5.85), longer duration of diabetes (odds ratio, 1.03 per year of diabetes; 95% confidence interval, 1.01 to 1.04), and being male (odds ratio, 1.93; 95% confidence interval, 1.34 to 2.77). CONCLUSION: These data suggest that control of hyperglycemia and prevention of gross proteinuria may lead to a reduction in the long-term incidence of hypertension.

Adult↗
PubMed1996

Relation of glycemic control to diabetic microvascular complications in diabetes mellitus.

OBJECTIVE: To describe the relation between glycated hemoglobin and the incidence or progression, or both, of diabetic microvascular complications in persons with insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). DESIGN: Population-based on cohort study. SETTING: An 11-county area in southern Wisconsin. PATIENTS: All persons with IDDM diagnosed before age 30 and taking insulin (n = 996) and a probability sample (based on duration of disease) of persons diagnosed with diabetes at age 30 or older who were either taking insulin (n = 674) or not taking insulin (n = 696) and who participated in a baseline examination from 1980 to 1982. Survivors of the cohort were re-examined again in 1984 to 1986 and 1990 to 1992. MEASUREMENTS: The incidence and progression of diabetic retinopathy was determined by masked grading of stereoscopic color fundus photographs using the modified Early Treatment Diabetic Retinopathy Study severity scale. Gross proteinuria was determined using a dipstick. Ten-year incidence of renal dialysis or transplantation or loss of tactile sensation or of temperature sensitivity was based on self-reported history. RESULTS: The glycated hemoglobin level at baseline was strongly related to the incidence or progression, or both, of diabetic retinopathy, the incidence of gross proteinuria, and the incidence of loss of tactile sensation or temperature sensitivity in persons with either IDDM or NIDDM. CONCLUSIONS: These prospective epidemiologic data suggest that glycemic control is similarly related to the incidence and progression of diabetic microvascular complications in both IDDM and NIDDM. However, further evidence from clinical trials in persons with NIDDM is necessary to assess the risks and benefits of such treatment in preventing these complications.

Age of Onset↗
PubMed1995

Potential interaction between annexin VI and a 56-kDa protein kinase in T cells.

Annexins belong to a large family of calcium-dependent phospholipid binding proteins known to undergo post-translational modifications such as phosphorylation. Physiological function of each annexin is still unclear since they may participate in signal transduction. We have tested the presence of annexins in a T cell line (Jurkat) and studied their phosphorylation by protein tyrosine kinases of the src family. Among annexins I, II, V and VI found in Jurkat cells, annexin VI was shown to be phosphorylated in vitro by p56lck and annexins I and II by p60src. We could not detect the phosphorylation of A-VI in vivo, even after cell stimulation. However, a 56-kDa phosphoprotein was found to be associated with A-VI after T cell activation. This 56-kDa protein shares some characteristics with p56lck.

Annexin A6↗
PubMed1995

Factors associated with having eye examinations in persons with diabetes.

OBJECTIVES: To estimate compliance with guidelines on ocular examinations for diabetic persons, to examine factors that affect compliance, and to determine reasons for noncompliance. DESIGN: Cross-sectional population study. SETTING: Primary care setting. PATIENTS: The population is 765 diabetic persons with younger onset and 533 with older onset who participated in the 1990 to 1992 follow-up examination of the Wisconsin Epidemiologic Study of Diabetic Retinopathy. MEASUREMENTS: A medical history was taken in which subjects were asked about eye examinations by ophthalmologists and optometrists. RESULTS: Sixty-four percent of the younger-onset group and 62% of the older-onset group had had a dilated eye examination in the previous year. Persons in both groups were more likely to have had a dilated examination if they had a longer duration of diabetes, more severe retinopathy, a history of glaucoma or cataract, and health insurance that covered eye examinations. Persons with younger-onset diabetes were more likely to have had an examination if they were older, were visually impaired, and had more education or higher income. Persons in the older-onset group were more likely to have had an examination if they were female or taking insulin. In those not having an eye examination, 79% and 71% of the younger- and older-onset groups, respectively, reported not having had one because they had no problems with their eyes, and 31% and 35% reported not having been told they needed one. Thirty-two percent and 11% said they were too busy, and 30% and 12% said they could not afford an examination. CONCLUSIONS: Diabetic persons should be educated as to the need for eye care; the results show that barriers to eye care exist in the form of affordability and lack of time.

Adolescent↗
PubMed1995

Age-related eye disease and survival. The Beaver Dam Eye Study.

OBJECTIVE: To investigate the relationship of cataract, age-related maculopathy, glaucoma, and visual impairment to survival in the population-based Beaver Dam Eye Study. DESIGN: In this population-based study, visual acuity was measured with use of standardized protocols. At baseline, stereoscopic color fundus photographs and color slit-lamp and retroillumination photographs were graded in a masked fashion to determine the presence of age-related maculopathy and cataract, respectively. Deaths were ascertained by contacting family members, daily review of obituaries, and use of vital status records. PARTICIPANTS: Subjects aged 43 through 84 years who lived in Beaver Dam, Wis, were identified and examined between 1988 and 1990. RESULTS: From the time of the baseline examination until a median of 4 years later, 9.5% (467/4926) of the population had died. After correcting for age and sex, poorer survival was associated with more severe nuclear sclerosis (5-year survival of 88.9% for the most severe compared with 94.1% for the least severe stage) and visual impairment (5-year survival of 87.5% for impaired compared with 91.8% for unimpaired vision). However, after controlling for systemic factors, only more severe nuclear sclerosis in people without diabetes was significantly associated with poorer survival (hazard ratio per level of severity, 1.19; 95% confidence interval, 1.00 to 1.40). CONCLUSIONS: These data suggest that after controlling for age and sex, nuclear sclerotic cataract severity, cataract surgery, and visual impairment are risk indicators for poorer survival. Cortical cataract, posterior subcapsular cataract, glaucoma, and age-related maculopathy were unrelated to poorer survival.

Adult↗
PubMed1995

A cohort study of the relationship of diabetic retinopathy to blood pressure.

OBJECTIVE: To determine whether blood pressure at baseline was associated with incidence or progression of diabetic retinopathy during a 10-year interval in a population-based cohort. PARTICIPANTS: A probability sample of all persons receiving primary care for diabetes in an 11-county area of southern Wisconsin were invited to participate in the study examinations in 1980 to 1982, 1984 to 1986, and 1990 to 1992. PROCEDURES: Blood pressure measurements, height, weight, ocular photographs, and glycosylated hemoglobin measurements were obtained and ocular examinations and a medical history interview were performed at each evaluation. MAIN OUTCOME MEASURES: Fundus photographs of seven standard photographic fields were obtained and graded according to the modified Airlie House Classification scheme. End points were incidence, any progression, or progression to proliferative diabetic retinopathy. RESULTS: At the baseline examination, 996 subjects were determined to have younger-onset diabetes and 1370 subjects had older-onset diabetes compared with 891 and 987, respectively, at the 4-year follow-up examination and 765 and 533, respectively, at the 10-year follow-up examination. In discrete linear logistic analyses, a 10-mm Hg increase in systolic blood pressure was significantly associated with incidence of retinopathy in subjects with younger-onset diabetes 10 years after the baseline examination (odds ratio, 1.27; 95% confidence interval, 1.03 to 1.57). No consistent association of blood pressure and retinopathy in subjects with older-onset diabetes was observed. Mortality did not affect the relationship of blood pressure and retinopathy. CONCLUSION: Increased systolic blood pressure at baseline was associated with a modest subsequent increased risk of incidence of diabetic retinopathy in subjects with younger-onset diabetes.

Adult↗
PubMed1995

Retinal microaneurysm counts and 10-year progression of diabetic retinopathy.

OBJECTIVE: To determine the relationship of change in the number of retinal microaneurysms to the 10-year progression to significant retinopathy, proliferative retinopathy, and clinically significant macular edema. DESIGN: Population-based study of persons with younger- and older-onset diabetes with 10 years of follow-up. SETTING AND PATIENTS: Eleven-county area in southern Wisconsin, where 189 patients with diabetes who had only retinal microaneurysms in photographs at baseline participated in 4- and 10-year follow-up examinations. OUTCOME MEASURES: Ten-year incidence of moderate nonproliferative diabetic retinopathy or worse, proliferative retinopathy, or clinically significant macular edema as determined by masked grading of stereoscopic color fundus photographs of seven standard fields. RESULTS: The increase in the number of retinal microaneurysms and the ratio of the number of retinal microaneurysms at the 4-year follow-up to the number at baseline were positively associated with incidence of proliferative retinopathy or clinically significant macular edema at the 10-year follow-up. Proliferative retinopathy was approximately 4.6 times and clinically significant macular edema was approximately 9.1 times more likely to develop at 10-year follow-up in eyes in which the number of microaneurysms increased by 16 or more from baseline to the 4-year follow-up than in eyes with no increase. Proliferative retinopathy was 3.4 times and clinically significant macular edema was 6.7 times more likely to develop at 10-year follow-up in eyes that had ratios of 3 or greater of the number of retinal microaneurysms at the 4-year follow-up to the number at baseline than in eyes in which the ratios were smaller. These relationships remained after controlling for the level of glycosylated hemoglobin and type of diabetes. CONCLUSIONS: Microaneurysm counts using stereoscopic color fundus photographs are an early important measure of progression of retinopathy and may serve as a surrogate end point for severe change in some clinical trials.

Adult↗
PubMed1995

Incidence of cataract surgery in the Wisconsin Epidemiologic Study of Diabetic Retinopathy.

PURPOSE: We studied the incidence of cataract extraction in people with diabetes of long duration to determine which factors are associated with higher risk of surgery. METHODS: We recruited a probability sample of all persons receiving care for diabetes in an 11-county area of southern Wisconsin for a prevalence study of diabetic retinopathy. All 2,366 subjects were examined between September 1980 and June 1982. During the slit-lamp examinations, presence of the lens, whether natural or prosthetic, was noted. The subjects were reexamined four and ten years after the initial prevalence study. Occurrence of cataract extraction in the interim between examinations was recorded. RESULTS: In the younger-onset group there was an 8.3% (95% confidence interval, 6.2%, 10.8%) cumulative incidence, and in the older-onset group there was a 24.9% (95% confidence interval, 21.3%, 28.5%) cumulative incidence of cataract surgery in the ten-year interval. Characteristics statistically significantly related to cataract surgery in the younger-onset group in multivariate analysis were age, severity of diabetic retinopathy, and proteinuria. In the older-onset group, age and use of insulin were associated with increased risk. CONCLUSIONS: These data indicate that cataract surgery is a relatively frequent occurrence in people with diabetes. This finding needs to be considered to plan for health care for people with diabetes.

Adolescent↗
PubMed1995

The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. The long-term incidence of macular edema.

BACKGROUND: As part of a population-based study of diabetes mellitus, the incidence of macular edema over a 10-year period and its relation to various risk factors are examined. METHODS: There were 891 younger-onset people with a diagnosis of having had diabetes before 30 years of age who were taking insulin at baseline examination and 987 older-onset people with a diagnosis of having had diabetes at 30 years of age or older who participated in baseline and 4-year examinations. Of these, 765 younger-onset and 533 older-onset people also participated in a 10-year examination. The presence of macular edema at baseline and follow-up examinations was determined from gradings of stereoscopic fundus photographs. RESULTS: The incidence of macular edema over the 10-year period was 20.1% in the younger-onset group, 25.4% in the older-onset group taking insulin, and 13.9% in the older-onset group not taking insulin. The incidence of macular edema over the 10-year period was associated with higher levels of glycosylated hemoglobin and more severe retinopathy in both younger- and older-onset groups, and with being female and increased diastolic blood pressure in the older-onset group. CONCLUSIONS: These data suggest a relatively high incidence of macular edema. The authors' data also suggest that a reduction in hyperglycemia may result in a beneficial decrease in the incidence of macular edema.

Adult↗
PubMed1995

Practical guidelines for the assessment and treatment of selective mutism.

OBJECTIVE: To provide practical guidelines for the assessment and treatment of children with selective mutism, in light of the recent hypothesis that selective mutism might be best conceptualized as a childhood anxiety disorder. METHOD: An extensive literature review was completed on the phenomenology, evaluation, and treatment of children with selective mutism. Additional recommendations were based on clinical experience from the authors' selective mutism clinic. RESULTS: No systematic studies of the phenomenology of children with selective mutism were found. Reports described diverse and primarily noncontrolled treatment approaches with minimal follow-up information. Assessment and treatment options for selective mutism are presented, based on new hypotheses that focus on the anxiety component of this disorder. Ongoing research suggests a role for behavior modification and pharmacotherapy similar to the approaches used for adults with social phobia. CONCLUSION: Selectively mute children deserve a comprehensive evaluation to identify primary and comorbid problems that might require treatment. A school-based multidisciplinary individualized treatment plan is recommended, involving the combined effort of teachers, clinicians, and parents with home- and clinic-based interventions (individual and family psychotherapy, pharmacotherapy) as required.

Anxiety Disorders↗
PubMed1995

Does insulin-like growth factor I predict incidence and progression of diabetic retinopathy?

We evaluated the relationship of insulin-like growth factor (IGF)-I to incidence and progression of diabetic retinopathy over a 6-year interval in a large population-based study of diabetes in southern Wisconsin. Participants included people with younger-onset diabetes (n = 66 adolescents, n = 661 adults > or = 18 years of age) and older-onset diabetes (n = 285 for those using insulin, n = 248 for those not using insulin). Fundus photographs were graded in a masked fashion using standardized protocols to determine the severity of retinopathy in each eye. Serum IGF-I levels were measured during 1984-1986 using a double-antibody radioimmunoassay. Mean IGF-I was highest in adolescents (499.1 micrograms/l), lower in younger-onset adult (280.1 micrograms/l), and lowest in the older-onset group (205.7 and 221.2 micrograms/l for older-onset group using insulin and not using insulin, respectively). The incidence of retinopathy was not significantly higher in people with higher IGF-I levels in any group. The odds of developing diabetic retinopathy in 6 years for each 10 micrograms/l increase in IGF-I after controlling for age, glycosylated hemoglobin, and duration of diabetes at baseline was 1.21 (95% confidence interval [CI] 0.95-1.54) for adolescents; 1.00 (95% CI 0.93-1.08) for younger-onset adults; 0.93 (95% CI 0.85-1.02) for the older-onset group using insulin; and 0.99 (95% CI 0.95-1.04) for the older-onset group not using insulin. In summary, IGF-I was not associated with 6-year incidence or progression of diabetic retinopathy in any of the groups.

Adolescent↗
PubMed1995

The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XVI. The relationship of C-peptide to the incidence and progression of diabetic retinopathy.

The relationship between plasma C-peptide and the 6-year incidence and progression of diabetic retinopathy was examined in a population-based study in Wisconsin. Individuals with younger-onset (n = 548) and older-onset (n = 459) diabetes were included. C-peptide was measured by radioimmunoassay with Heding's M1230 antiserum. Retinopathy was determined from stereoscopic fundus photographs. Younger- and older-onset insulin-using individuals with undetectable or low plasma C-peptide (< 0.3 nmol/l) at baseline had the highest incidence and rates of progression of retinopathy, whereas older-onset individuals with C-peptides > 0.3 nmol/l had the lowest incidence and rates of progression of retinopathy. However, within each group (younger-onset using insulin, older-onset using insulin, and older-onset not using insulin), after we controlled for other characteristics associated with retinopathy, there was no relationship between higher levels of C-peptide at baseline and lower 6-year incidence or progression of retinopathy. These data suggest that glycemic control, and not C-peptide, is related to the incidence and progression of diabetic retinopathy.

Adult↗
PubMed1995

Ten-year incidence of gross proteinuria in people with diabetes.

There are few population-based epidemiological data describing the long-term incidence of gross proteinuria in people with diabetes. We performed a population-based study in southern Wisconsin of individuals with diabetes diagnosed at either < 30 years of age and taking insulin (younger-onset, n = 666) or > or = 30 years of age either taking (older-onset taking insulin, n = 376) or not taking insulin (older-onset not taking insulin, n = 418). The presence of gross proteinuria (> or = 0.3 g/l) was determined by means of a reagent strip. The incidence of proteinuria in the 10-year interval was 28% in the younger-onset group, it was 40% in the older-onset group taking insulin, and it was 33% in the older-onset group not taking insulin. After we controlled for other risk factors, the 10-year incidence of proteinuria was significantly related to higher glycosylated hemoglobin level and diastolic blood pressure at baseline and to an increase in glycosylated hemoglobin level and an increase in diastolic blood pressure from baseline to the 4-year follow-up in the younger-onset group and to higher glycosylated hemoglobin level, higher systolic blood pressure, and higher total pack-years of cigarettes smoked at baseline and an increase in systolic blood pressure from baseline to the 4-year follow-up in the older-onset groups. These data suggest that modification of three factors--hyperglycemia, high blood pressure, and smoking--may lead to a reduction in the long-term incidence of proteinuria.

Adult↗
PubMed1995

Digoxin does not accelerate progression of diabetic retinopathy.

OBJECTIVE: To test the hypothesis that digoxin, an inhibitor of Na(+)-K(+)-ATPase activity, accelerates the progression of diabetic retinopathy. RESEARCH DESIGN AND METHODS: We compared the incidence and risk of retinopathy in 120 digoxin-taking vs. 867 non-digoxin-taking diabetic participants in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) and in 117 digoxin-taking vs. 1,883 non-digoxin-taking diabetic subjects in the Early Treatment Diabetic Retinopathy Study (ETDRS). In both studies, retinopathy was detected by grading stereoscopic color photographs using the modified Airlie House classification scheme, and a two-step difference in baseline retinopathy grade was considered significant. RESULTS: After controlling for other risk factors, we found no statistically significant association with either 4-year incidence of retinopathy (WESDR) or progression of retinopathy (WESDR and ETDRS) in patients taking digoxin at baseline compared with those not taking digoxin. CONCLUSIONS: These data suggest that digoxin therapy does not adversely affect the course of diabetic retinopathy.

Adult↗
PubMed1995

Older-onset diabetes and lens opacities. The Beaver Dam Eye Study.

PURPOSE: To determine the prevalence of lens opacities in older-onset diabetic persons. METHODS: A study of age-related eye disease in a population (n = 4926) of adults in Beaver Dam, Wisconsin. Study participants were examined and interviewed according to protocol. Photographs were taken of the lenses of both eyes of all study participants. Photographs were graded in a standard fashion. Diabetes was defined by history, doctors' records and serum glucose criteria. RESULTS: Persons who were diabetic were significantly more likely to have cortical lens opacities (age-adjusted odds ratio 1.72, 95% CI 1.29-2.30 for right eyes) and were more likely to have previously undergone cataract surgery (age-adjusted odds ratio 2.01, 95% CI 1.43-2.82 for either eye) than people without diabetes. Longer duration of diabetes significantly increased the odds of having cortical opacity. CONCLUSION: Older-onset diabetes is associated with increased frequency of a specific age-related lens change, cortical opacity. It is also associated with increased frequency of cataract surgery.

Adult↗
PubMed1995

The relationship of age-related maculopathy, cataract, and glaucoma to visual acuity.

PURPOSE: To investigate the relationship of age-related maculopathy, cataract, and glaucoma to visual acuity in the population-based Beaver Dam Eye Study. METHODS: A cross-sectional, population-based study was performed in people 43 through 86 years of age residing in Beaver Dam, Wisconsin, who were identified between 1987 and 1988 and examined (n = 4926) between 1988 and 1990. Of those who participated, 99.4% were white. Visual acuity was measured (n = 4886) using a modification of the Early Treatment Diabetic Retinopathy Study protocol. Stereoscopic color fundus photographs and slit lamp and retroillumination photographs of the lens were graded in a masked fashion using standardized protocols to determine the presence of age-related maculopathy and central cataract. RESULTS: Fifty-seven percent of those who were legally blind had late age-related maculopathy in both eyes. The frequency of visual acuity of 20/200 or worse was not significantly different in eyes with exudative macular degeneration (48%) than in eyes with pure geographic atrophy (42%). While controlling for other factors (age, central cataract, and glaucoma) in participants with both gradable age-related maculopathy and visual acuity measurable in at least one eye (n = 4716), investigators found that each of the early age-related maculopathy lesions was associated with a decrease in visual acuity of approximately two letters or fewer when compared to eyes without these lesions. Late age-related maculopathy was associated with a decrease of approximately seven lines of letters read correctly. CONCLUSION: These data demonstrate that exudative macular degeneration and pure geographic atrophy are the most important causes of legal blindness in this population and that early age-related maculopathy, central cataract, and glaucoma had a small effect on visual acuity.

Adult↗