The American journal of the medical sciences
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Comparative Study
Decreased insulin-mediated but not non-insulin-dependent glucose disposal rates in glucose intolerance and type II diabetes in African (Ghanaian) immigrants.
The authors evaluated the significance of beta cell function, non-insulin-dependent glucose disposal (glucose effectiveness [Sg]), and insulin-dependent glucose disposal (insulin sensitivity) in African immigrants with varying degrees of glucose tolerance. Thirty-two African immigrants residing in Franklin County, Ohio, were studied. There were 16 subjects with normal glucose tolerance (NGT), 11 with intermediate glucose tolerance (IGT), and 5 with type II diabetes mellitus (DM). ⋯ In summary, the authors demonstrate that, in native African immigrants, type II diabetes is associated with significant reduction in beta cell function, insulin sensitivity, and glucose decay constant, but not in Sg. In patients with intermediate or impaired glucose tolerance, there is moderate insulin resistance and evidence of inadequate compensation by beta cell, but the Sg, the Sg at theoretical insulin concentration, and glucose decay constant remain normal. They conclude that, unlike other ethnic and racial groups, in glucose intolerant native African patients, alterations in Sg or non-insulin dependent glucose disposal (ie, tissue glucose sensitivity) do not appear to play a significant role in the impairment of glucose tolerance and type II diabetes in African immigrants.
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A long term study of diversity between two ethnic groups was developed in Evans County, Georgia. The findings are predicated on the genotypic-phenotypic interactions, with the multitude of environmental factors. The genetic-environmental interaction ultimately determines the individual's state of health or disease. ⋯ Cultural adaptation has accelerated hypertensive disease and strokes in blacks, while there remains an excess of atherosclerotic coronary heart disease in white men. Secular trends suggest that coronary heart disease is decreasing among white men but may be increasing in black men. Studies of ethnicity and biracial populations provide important cardiovascular disease associations with clinical risk factor studies.
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Review Comparative Study
Does Lyme disease occur in the south?: a survey of emerging tick-borne infections in the region.
Lyme disease is the most common arthropod-borne infection in the United States. However, the risk of infection varies widely by geographic region. In the South, Borrelia burgdorferi has been identified in ticks and small mammals, but transmission of the agent to humans has not been documented. The Lyme disease-like disorder reported from the region may have another etiology.
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In recent years, numerous previously known infections pathogens and their associated diseases have been recognized. Among these newly identified agents are the viruses that cause the hemorrhagic fevers, including Sin Nombre virus, the etiologic agent of the 1993 outbreak of hantavirus pulmonary syndrome in the American Southwest. Epidemiologic and laboratory investigations of the hemorrhagic fevers and their etiologic agents provide lessons that may be used collectively as a paradigm of the nature of emerging and re-emerging infectious diseases.
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The ability of many different species of bacteria, including those that cause diseases in humans, to resist the inhibitory action of antimicrobial agents has become a global problem. Resistance continues to spread not only in nosocomial pathogens but in several key community-acquired organisms as well. ⋯ In addition, although the epidemiology of resistant organisms sometimes is similar to that of susceptible organisms of the same kind, in some situations it may be quite different. In this article, the authors highlight some of the pathways leading to the development of resistance in bacteria, the importance of antimicrobial use, and the relevance of these mechanisms to measures for the control of resistant bacteria in hospital and community settings.