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PubMed1995

Optimization of radiographic technique for chest radiography.

Over 1500 patients undergoing chest radiography in the West Midlands have been monitored for entrance surface doses using lithium borate thermoluminescent dosemeters. In total 63 X-ray tubes were monitored from 30 hospital departments. The mean patient entrance surface dose is 0.15 mGy, and the 75th percentile entrance surface dose is 0.18 mGy. A reference level of 0.18 mGy has been recommended for PA chest radiography in the West Midlands. Image quality has been assessed on patient radiographs. Departmental radiologists were responsible for assessing radiographs taken within their hospital. Independent analysis was performed by a control radiologist. Film-screen processor sensitivity has been assessed on 48 film-screen processor combinations. Significant differences were observed between the nominally quoted sensitivities and the measured sensitivities. Only 26% of systems produced measured sensitivities within 10% of the nominal values. A four variable regression model, explaining 78% of the variance, provided the best description for the variation in patient dose. These variables were actual sensitivity, applied potential, generator waveform and radiographic quality. Four recommendations have been made to lower patient doses; these are: (1) an increase in applied potential to a minimum of 90 kVp; (2) a film-screen sensitivity of 400; (3) optimization of processor performance and (4) regular radiological audits to reduce repeat rates to a level of 5%. If all of these recommendations are followed, an estimated overall entrance surface dose saving of 53% would result. Changing the applied potential alone will see the variation in the mean entrance surface dose from non-gridded systems reduce from a factor of 4 to a factor of 2.

Humans↗

PubMed2004

Correlates of strength training in older rural African American and Caucasian women.

This study examined factors influencing strength training (ST) in two convenience samples of older rural women. Focus group (FG) participants were 23 Caucasian and 16 African American women aged 67.5 +/- 9.2 years. Survey participants were 60 Caucasian and 42 African American women, aged 70.59 +/- 9.21 years. FG participants answered questions about the risks, benefits, and barriers to ST. Survey participants completed measures of demographics, physical activity (including ST), depression and stress, decisional balance for exercise (DBE), barriers to PA, and social support (SS). Regression modeling examined correlates of ST. FG participants identified physical health gains and improved appearance as ST benefits. African American women also included mental health benefits and "feeling good". Both Caucasian and African American groups named physical health problems as risks of ST. Caucasian women identified time constraints, lack of ST knowledge, physical health problems, lack of exercise facilities, and the cost of ST as barriers. African American women cited being "too tired", physical health problems, lack of support, and other family and work responsibilities. The linear regression model explained 23.2% of the variance in hours per week of ST; DBE and family SS were independent positive correlates. This study identified correlates to participation in ST in older rural women and provides a basis for developing ST interventions in this population.

Black or African American↗

PubMed2006

Unmet patient need in home care under managed care.

Social workers in home care agencies obtained through a national random sample responded to a mail questionnaire that examined the relationship between the frequency of discharge with unmet patient need and patient/family characteristics, agency auspice, and practice activities when social workers' assessment of patient needs and managed care payment limits conflict. Regression analysis found that the importance of social work financial planning with clients and intra-agency advocacy were significant negative contributors, and patient cognitive impairment, inadequate family care, and agency auspice were significant positive contributors to a regression model explaining 31 percent of the variance in the frequency of discharge with unmet need. Implications for practice, education, and research are discussed.

Aged↗

PubMed2005

Understanding how attitudes affect physician compliance with legal behavioral constraints.

The following study investigates how physicians in one state (Illinois) attitudinally cope with a recent law mandating physician behaviors. Specifically, this study focuses on OB/GYN physician compliance with The Sexual Assault Survivors Emergency Treatment Act (Public Law 92-156, 2002), which requires hospitals in the state of Illinois to have an approved plan for treating sexual assault survivors. What makes this research setting interesting are the potential linkages between the legal mandate, physician attitudes, and the ongoing controversy concerning abortion. The results of a census of OB/GYN physicians within the state suggest (1) this physician group is largely supportive of the letter and spirit of this law, (2) the emerging attitude models such as Perugini and Bagozzi's (2001) MGB model explaining the formation of behavioral intentions must be treated with caution when generalizing to situations mandating legal behaviors, and (3) moderating influences such as attitude strength and religiosity have no apparent effect in how attitudes relate to physician motivation to comply with such laws. The managerial and research implications of the reported study are presented and discussed.

Attitude of Health Personnel↗

PubMed2005

Non-clinical factors associated with variation in cataract surgery waiting times in Manitoba.

Cataract surgery is the highest-volume surgical procedure in Canada, with over 200,000 performed annually, mostly (85%) on persons aged 65 or older. Concerns have been raised about wait times to access this procedure. This study explores the relationship between waiting times for cataract surgery in Manitoba and a variety of characteristics, including age, sex, socio-economic status, region of residence, health status, surgeon, and surgeon's caseload. The study included 6114 individuals who had first-eye cataract surgery between November 1, 1998, and March 31, 2000, in Winnipeg, MB. Significant predictors of variation in wait times were age, sex, having a hospitalization while waiting, and surgeon. The model explained 32.5 per cent of the variance in wait times; specific surgeon independently explained 29.5 per cent of the variance. Median waiting times varied widely by surgeon, ranging from 61 to 399 days. Differences in surgeons' expected wait times should be available to patients and referring clinicians.

Aged↗

PubMed2001

Estrogen receptor alpha gene polymorphisms and bone mineral density: haplotype analysis in women from the United Kingdom.

Genetic factors are important in the pathogenesis of osteoporosis and the estrogen receptor has been suggested as a possible candidate gene for regulation of bone mineral density (BMD). We investigated the relationship between PvuII, XbaI, and dinucleotide (TA)n repeat polymorphisms of the estrogen receptor alpha (ER-alpha) gene and BMD in a study of women from northeast Scotland in the United Kingdom. No significant association was observed between BMD values at the lumbar spine (LS) and femoral neck (FN) in relation to PvuII and XbaI polymorphisms individually, but haplotype analysis showed that BMD values (Z score) were significantly lower in those who carried the Px haplotype (n = 36) compared with those who did not (n = 170) at both the LS (mean +/- SEM; -0.775 +/- 0.125 vs. -0.285 +/- 0.082;p = 0.002) and the FN (-0.888 +/- 0.130 vs. -0.335 +/- 0.083; p = 0.0006). In keeping with this, the Px haplotype also was found to be an independent predictor of LS BMD (p = 0.019) and FN BMD (p = 0.005) in a multiple regression analysis model that included other possible predictors of BMD including age, years since menopause (YSM), hormone-replacement therapy (HRT) use, weight, and height. This model explained 15.7% and 23.4% of the total observed variance in LS and FN BMD, respectively, with the Px haplotype accounting for approximately 3% of the variance at both sites. Although the TA repeat polymorphism was in strong linkage disequilibrium (LD) with the PvuII (chi2 = 109.8; p < 0.0001) and XbaI (chi2 = 97.2; p < 0.0001) polymorphisms, there was no overall association between TA repeat number and BMD. We conclude that polymorphisms of the ER-alpha gene are significantly related to BMD in our population and that this association is dependent on the Px haplotype, suggesting that it is the Px haplotype, or a linked polymorphism, that confers risk.

Alleles↗

PubMed2004

Assessment of emphysema in COPD: a functional and radiologic study.

OBJECTIVES: A combination of functional measurements reflecting a decrease in maximum flow, a degree of lung hyperinflation, the relationship between maximum inspiratory and expiratory flows, bronchodilator response, and diffusing capacity of the lung for carbon monoxide (DLCO) was used to quantify the extent of emphysema, as assessed by high-resolution CT (HRCT) scanning. DESIGN: Forced inspiratory and expiratory spirometry, lung volumes, reversibility test, and single-breath diffusing capacity were assessed before and after inhaling albuterol, 200 microg. Relationships between lung function variables and emphysema extent, as determined by HRCT scanning, were tested by univariate and multivariate analyses. SUBJECTS: Thirty-nine COPD outpatients with moderate-to-severe obstruction. MEASUREMENTS AND RESULTS: Emphysema extent, as assessed by HRCT scanning, ranged from 18 to 70%. All of the lung function parameters that were studied, except for the change in FEV1 percent predicted after salbutamol inhalation, correlated significantly with the extent of emphysema (r2 range, 0.19 to 0.44). Functional residual capacity, forced expiratory flow at 50% of FVC/forced inspiratory flow at 50% of FVC, DLCO/alveolar volume ratio, and bronchodilator-induced change in FEV1/FVC ratio were the only variables retained by stepwise multiple regression analysis. The multiple regression model explained 71% of the variability of emphysema extent measured by HRCT scanning. CONCLUSIONS: The combination of lung function measurements reflecting lung hyperinflation, bronchial collapsibility, lung diffusing capacity, and bronchodilator response provides a good estimate of the extent of emphysema, as evaluated by HRCT scanning. These data suggest that pulmonary function tests are useful in assessing and monitoring parenchymal damage in COPD patients.

Aged↗

PubMed1998

Prolactin receptor antagonists.

Most prolactin (PRL) in the circulation is produced by the pituitary. However, a wide variety of traditional target tissues of the hormone have also been shown to produce their own prolactin. The amount produced per cell is low, but may well be sufficient for autocrine/paracrine activity. Although dopamine agonists allow one to study the target tissue effects of pituitary PRL, other agents, such as PRL receptor (PRLR) antagonists, are needed to analyze autocrine/paracrine loops. With PRLR antagonists, it should be possible to dissect out the role of extrapituitary prolactin in both the normal physiology, and the pathophysiology of various tissues. In tissues where the locally produced PRL may promote disease, such antagonists have the potential to be important therapeutics. This article briefly, but critically, reviews current understanding of PRL-receptor interactions and initial signaling, and describes the development of both growth hormone (GH) and PRL antagonists within that context. In the final section, results with a very potent PRL antagonist further one theme of the article, which is whether the simple receptor dimerization model explains all signal transduction following PRLR binding.

Animals↗

PubMed2004

First evidence for helical transitions in supercoiled DNA by amyloid Beta Peptide (1-42) and aluminum: a new insight in understanding Alzheimer's disease.

Previously, we evidenced a B --> Z helical change in Alzheimer's brain genomic DNA, leading to a hypothesis that Alzheimer's disease (AD) etiological factors such as aluminum (Al), amyloid beta (Abeta) peptide, and Tau might play a role in modulating DNA topology. In the present study, we investigated the interaction of Al and Abeta with DNA. Our results show that Abeta(1-42) could induce a B --> Psi (Psi) conformational change in pUC 18 supercoiled DNA (scDNA), Abeta(1-16) caused an altered B-form, whereas Al induced a complex B-C-A mixed conformation. Ethidium bromide binding and agarose gel electrophoresis studies revealed that Al uncoiled the DNAto a fully relaxed form, whereas Abeta(1-42) and Abeta(1-16) effected a partial uncoiling and also showed differential sensitivity toward chloroquine-induced topoisomer separation. Our findings show for the first time that Abeta and Al modulate both helicity and superhelicity in scDNA. A new hypothetical model explaining the potential toxicity of Abeta and Al in terms of their DNA binding properties leading to DNA conformational alteration is proposed.

Aged↗

PubMed2005

Specialty and sex as predictors of depression in dentists.

BACKGROUND: Stress, burnout, substance abuse and suicide among dentists have been studied, yet no study in the United States has specifically addressed depression in e dentists. The objective of the authors' study was to determine if sex and dental specialty were correlated with depression in dentists. METHODS: The authors conducted a survey of a sample of dentists chosen randomly from the American Dental Association's mailing list of member dentists. The survey, stratified by sex and specialty, resulted in 560 responses, for a 53 percent response rate. The authors used the Zung Self-Rating Depression Scale to measure depression. The authors examined the respondents' sex, age, number of children, marital status, specialty, practice type, location of practice, years in practice and hours worked per week. RESULTS: The rate of depression in the overall sample was 9 percent. Sex was associated with depression (P < .001), but specialty was not. However, multiple regression analysis found that sex was significantly related to depression in only two specialties: periodontics and pediatric dentistry. Overall, the regression model explained an unimpressive 6 percent of the variance in depression scores. The most important finding of the study was that only 15 percent of depressed dentists were receiving treatment. CONCLUSIONS: The survey results showed that only female pediatric dentists and periodontists were more depressed than their male counterparts. None of the other variables studied contributed significantly to the understanding of depression in dentists. Depressed dentists, like other depressed people, tend not to seek treatment. CLINICAL IMPLICATIONS: Depression and serious depression occur among dentists, and much of it is untreated. Because depression is harmful to dentists and raises quality-of-care issues, they should be educated to help them recognize depression and encouraged to seek treatment.

Adult↗

PubMedDate not supplied

A population-based study of 18-year old Swedish youths and factors correlated with their total number of lifetime sexual partners.

UNLABELLED: The number of sexual partners has in studies been shown to be a factor correlated with STI but there is little published knowledge on what factors are associated with number of sexual partners. OBJECTIVES: To examine which variables are correlated with the number of lifetime sexual partners (NLSP) among youths. STUDY GROUP: All 18-year old girls and boys in four cities in northern Sweden. METHODS: A population-based study where participants answered a questionnaire regarding their social lifestyle, psychological and sexual health. The associations between these independent variables and the dependent variable (NLSP) were investigated by multivariate linear regression analysis. RESULTS: The boy and girl median NLSP was 2.0 (P25 =1.0, P75=3.0). The final model explained 29% of the total boy NLSP variation and 46% of the total girl NLSP variation. Eight boy variables and thirteen girl variables significantly correlated with NLSP were found. The two strongest variables associated with increased NLSP among boys and girls, was feelings of guilt or shame after sex and smoking regularly. Variables prior associated with an increased risk of acquiring STI's were associated with increased NLSP. The study found new gender differed behaviour variables correlated to NLSP not previously considered to be risk factors for STI. CONCLUSIONS: To prevent the spread of STI it is important that persons with many partners are identified, treated if necessary and possible, or encouraged to change their behaviour. The study found several boy and girl variables associated with increased NLSP, which could facilitate both primary- and secondary preventions.

Adolescent↗

PubMed2004

Beer consumption and premature mortality in Louisiana: an ecologic analysis.

OBJECTIVE: This study was conducted to determine whether beer consumption is associated with premature mortality across municipalities in Louisiana. METHOD: We conducted a cross-sectional ecologic study using tax data on the sales of beer and mortality data from Louisiana. We aggregated deaths that occurred before the age of 65 to the level of the municipality and calculated age-adjusted rates of both overall premature mortality and specific causes of premature mortality that may be related to alcohol. After controlling for potential confounders including population distributions for race, income, employment and education, we examined whether beer sales were independently associated with premature mortality rates due to homicides, unintentional injuries, other acute alcohol-related causes, liver diseases, cardiovascular disease and other chronic alcohol-related causes. RESULTS: After controlling for race and socioeconomic status, municipalities with greater beer consumption had higher premature mortality, with the model explaining up to 24% of all premature deaths. Beer consumption was also independently associated with homicide, liver diseases and cardiovascular disease. Neither unintentional injuries nor other chronic alcohol-related causes of mortality were significantly associated with beer consumption. CONCLUSIONS: The population-level association between beer consumption and mortality may reflect population-level determinants of beer consumption as well as indirect health effects of alcohol consumption on persons who are not heavy drinkers.

Adolescent↗

PubMed2006

Alcohol craving in outpatients with alcohol dependence: rate and clinical correlates.

OBJECTIVE: The present study was undertaken to assess the rate and severity of alcohol craving symptoms among registered alcohol-dependent patients at a Veterans Affairs outpatient clinic. We also examined the relationship between alcohol craving and the clinical characteristics of alcohol-dependent patients. METHOD: Participants included 101 alcohol-dependent veterans enrolled in an outpatient addiction clinic. Alcohol craving was measured by the Penn Alcohol Craving Scale. Alcoholism severity and clinical characteristics were assessed with the Addiction Severity Index, Timeline Followback method, and other instruments. Three alcohol-craving groups (low, moderate, and high) were identified and compared using their demographic and clinical characteristics. Multiple regression analysis was performed to evaluate the relationship between the potential predictors and alcohol craving. RESULTS: The rate of alcohol craving was as follows: low craving (46%), moderate craving (29%), and high craving (25%). When these three craving groups were compared using univariate analyses, patients with higher alcohol craving had significantly higher alcohol composite scores (last 30 days) and severe alcohol dependence (last 1 year). In multiple regression analysis, the model explained 50% of the variance in alcohol craving, with alcoholism severity (42%), withdrawal symptoms (5%), and depression (3%) as significant predictors. CONCLUSIONS: Patients in an outpatient treatment setting had a wide range of alcohol cravings. Level of alcohol craving was directly associated with several increased indices of alcohol- and non-alcohol-related morbidity.

Alcoholism↗

PubMed1995

Influence of thyroid hormones on the regulation of growth hormone secretion.

The effects of thyroid hormones on GH secretion and the mechanisms underlying their action are very similar in man and the laboratory animal. We feel that it is possible to organize the available data into a unique pathophysiological model explaining these complex interactions (Table 1). In summary, physiological levels of circulating thyroid hormones are necessary to maintain normal pituitary GH secretion owing to their direct stimulatory actions. When the serum concentrations of thyroid hormone increase above the normal range there is an increase in hypothalamic somatostatin tone, which in turn suppresses pituitary GH secretion and overrides any stimulatory effects. The suppression of GH secretion by thyroid hormones may be mediated at the hypothalamic level also by a decrease in GHRH release.

Animals↗

PubMed2000

The discrepancy between maturation of visual-evoked potentials and cognitive outcome at five years in very preterm infants with and without hemodynamic signs of fetal brain-sparing.

OBJECTIVE: After intrauterine growth restriction we found at the age of 6 months an acceleration of neurophysiologic maturation. However, at later ages impaired cognitive outcome has been reported. Therefore, we investigated in children with and without fetal hemodynamic adaptation to intrauterine growth restriction whether the accelerated neurophysiologic maturation in infancy might be associated with impaired cognitive outcome at preschool age. DESIGN: At 5 years of age cognitive function was assessed using the Revision of the Amsterdam Children's Intelligence Test in 73 preterm infants (26-33 weeks) who were prospectively followed from the antenatal period up to the age of 5 years. Maternal educational level was used as a background variable to estimate the confounding effects of socioeconomic status on cognitive function. Fetal Doppler studies were performed and the umbilical artery pulsatility index (PI) divided by the middle cerebral artery PI ratio (U/C ratio) was calculated. A U/C ratio >0.725 was considered as an indication of fetal cerebral hemodynamic adaptation to a compromised placental perfusion, ie, fetal brain-sparing. Visual-evoked potentials (VEPs) were recorded at 6 months and 1 year of age. In addition, data on neurologic status at 3 years were available. RESULTS: Mean IQ score was significantly lower for children born with a raised U/C ratio (87 +/- 16) compared with children with a normal U/C ratio (96 +/- 17). VEP latencies decreased significantly in infants with a normal U/C ratio, whereas no decrease was found in infants with a raised U/C ratio. Variables contributing significantly to the variance of cognitive function were: U/C group, VEP latency maturation, level of maternal education, and neurodevelopmental outcome at 3 years. The linear regression model explained 33% of the variance in cognitive function. CONCLUSIONS: Both being born with a raised U/C ratio and an acceleration of VEP latencies are negatively associated with cognitive outcome at 5 years of age. Fetal brain-sparing, although a seemingly beneficial adaptive mechanism for intact neurologic survival, is, however, later associated with a poorer cognitive outcome.

Adaptation, Physiological↗

PubMed2003

Psychopathology and social competencies of adolescents who were extremely low birth weight.

BACKGROUND: We have previously shown that infants who were extremely low birth weight (ELBW) are particularly vulnerable to problems related to inattention and hyperactivity at school age. It is not known whether these problems persist to adolescence. OBJECTIVE: To explore and compare the levels of psychopathology in a regional cohort of ELBW infants and sociodemographically matched term controls as reported by teens and their parents. DESIGN/METHODS: Cross-sectional cohort study/geographically defined region. PARTICIPANTS: TEENS: ELBW 141/169 (83%) and control 122/145 (84%), aged 12 to 16 years. PARENTS: ELBW 143/169 (85%) and control 123/145 (85%). Both cohorts and their parents completed the Ontario Child Health Study-Revised questionnaire with 6 behavioral subsca1es: conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), overanxious, separation anxiety, and depression. RESULTS: By teen self-report, there were no significant differences between ELBW and control teens on any of the 6 subscale scores. However, parents of ELBW teens reported significantly higher scores than parents of control for depression and ADHD based on 2-way analysis of variance (group x gender). Comparison within teen/parent dyads showed that both cohorts of teens reported significantly higher scores than their parents. Multivariable analyses on behavioral subscale scores demonstrated a number of variables that were significant predictors by parent report: group (ELBW vs control), gender, family function, developmental quotient, maternal mood, and socioeconomic status; no predictors were significant by teen report. There were no statistically significant interaction effects for any of the models. These models explained a greater percent of the variance in behavioral scores for parents than for teens (12.5%-22.0% vs 3.4%-8.2%). Results were similar when teens with neurosensory impairment were excluded. CONCLUSIONS: This study is unique in the inclusion of both parent and teen self-report of behaviors. Significant differences were apparent only by parent report for ADHD and depression among ELBW teens. Significant predictors of behavioral scores for parents include group, gender, family function, developmental quotient, maternal mood, and socioeconomic status.

Adaptation, Psychological↗

PubMed2006

Dietary electrolyte-driven responses in the renal WNK kinase pathway in vivo.

WNK1 and WNK4 are unusual serine/threonine kinases with atypical positioning of the catalytic active-site lysine (WNK: With-No-K[lysine]). Mutations in these WNK kinase genes can cause familial hyperkalemic hypertension (FHHt), an autosomal dominant, hypertensive, hyperkalemic disorder, implicating this novel WNK pathway in normal regulation of BP and electrolyte balance. Full-length (WNK1-L) and short (WNK1-S) kinase-deficient WNK1 isoforms previously have been identified. Importantly, WNK1-S is overwhelmingly predominant in kidney. Recent Xenopus oocyte studies implicate WNK4 in inhibition of both thiazide-sensitive co-transporter-mediated Na+ reabsorption and K+ secretion via renal outer medullary K+ channel and now suggest that WNK4 is inhibited by WNK1-L, itself inhibited by WNK1-S. This study examined WNK pathway gene expression in mouse kidney and its regulation in vivo. Expression of WNK1-S and WNK4 is strongest in distal tubule, dropping sharply in collecting duct and with WNK4 also expressed in thick ascending limb and the macula densa. These nephron segments that express WNK1-S and WNK4 mRNA have major influence on long-term NaCl reabsorption, BP, K+, and acid-base balance, processes that all are disrupted in FHHt. In vivo, this novel WNK pathway responds with significant upregulation of WNK1-S and WNK4 with high K+ intake and reduction in WNK1-S on chronic lowering of K+ or Na+ intake. A two-compartment distal nephron model explains these in vivo findings and the pathophysiology of FHHt well, with WNK and classic aldosterone pathways responding to drivers from K+ balance, extracellular volume, and aldosterone and cross-talk through distal Na+ delivery regulating electrolyte balance and BP.

Aldosterone↗

PubMed1996

Renal findings in patients with short-term type 2 diabetes.

Under semiambulatory conditions, 85 consecutive patients with the diagnosis of Type 2 diabetes of short duration (excluding patients with islet cell antibodies or maturity onset diabetes of the young) were admitted to a self-control training program and were examined in this study. A comprehensive renal assessment was performed, including evaluation of albumin excretion rate (AER), renal hemodynamics, blood pressure (BP) profile, and indicators of genetic risk. AER > or = 30 mg/24 h was found in 13 (15%) of patients; in two of these patients, AER was > or = 300 mg/24 h. By logistic regression, high HbA1, current smoking, and BP parameters were significantly correlated with an increased risk of microalbuminuria (MA). In a multiple linear regression model, accounting for 57% of total variance, HbA1, ERPF, and current smoking were significantly correlated with AER. Median GFR (Cin(inulin clearance) 136 mL/min per 1.73m2; range, 94 to 194) and ERPF (Cpah(para-aminohippuric acid clearance) 733; range, 451 to 1328) were significantly higher in patients than in control subjects (upper 95th percentile, 131 and 706 mL/min per 1.73m2, respectively). In a multiple linear regression model, explaining 27% of total variance, age, AER, gender, and fasting blood glucose were significantly correlated to GFR. According to the criteria of average daytime BP > or = 135/85 mm Hg or 24-h BP > or = 130/80 mm Hg, 60% of patients were hypertensive (HT). Sixty-one percent of all patients (including 50% of the untreated normotensive patients) were "nondippers", i.e., < 15% nighttime decrease of mean arterial pressure. Either HT or nondipping was found in 79% of all patients, so that only 21% had a completely normal blood pressure profile. Ninety-four percent of untreated hypertensive patients had no MA. First-degree relatives of patients with MA compared with patients without MA had more frequent cardiovascular events (69% versus 31%). The risk of MA in diabetic patients with positive family history was amplified by poor glycemic control. MA, but not hypertension, was marginally related to K(m) of Na+/Li+ countertransport. It was concluded that (1) microalbuminuria is found in 15% of patients newly presenting with Type 2 diabetes; (2) a high proportion of patients exhibit hyperfiltration; (3) according to ambulatory BP only, 21% of patients have a completely normal circadian BP profile; (4) a family history of cardiovascular events interacts with glycemic control to increase the risk of MA.

Adult↗