Close relation of fasting insulin-like growth factor binding protein-1 (IGFBP-1) with glucose tolerance and cardiovascular risk in two populations.

Aims/hypothesis: Insulin resistance/hyperinsulinaemia is implicated in the development of cardiovascular disease and diabetes but its role and causal pathways are not clear. We tested the hypothesis that the insulin-like growth factor system is independently associated with cardiovascular risk within susceptible populations based on previous reports of the links between low circulating insulin-like growth factor binding protein-1 concentrations and increased macrovascular disease in Type II (non-insulin-dependent) diabetes mellitus.

Methods: In a population-based study 272 subjects (142 subjects of European and 130 Pakistani of origin) underwent a 75 g oral glucose tolerance test and standardised anthropometry.

Hypertension in four African-origin populations: current 'Rule of Halves', quality of blood pressure control and attributable risk of cardiovascular disease.

Objective: To assess the public health burden from high blood pressure and the current status of its detection and management in four African-origin populations at emerging or high cardiovascular risk.

Design: Cross-site comparison using standardized measurement and techniques.

Setting: Rural and urban Cameroon; Jamaica; Manchester, Britain.

Sick genes, sick individuals or sick populations with chronic disease? The emergence of diabetes and high blood pressure in African-origin populations.

Aim And Methods: To discuss evidence for and against genetic 'causes' of type 2 diabetes, illustrated by standardized study of glucose intolerance and high blood pressure in four representative African origin populations. Comparison of two genetically closer sites: rural (site 1) and urban Cameroon (2); then Jamaica (3) and Caribbean migrants to Britain (80% from Jamaica-4).

Background: Alternatives to the reductionist search for genetic 'causes' of chronic disease include Rose's concept that populations give rise to 'sick' individuals.

Blood transfusion: crucial steps in maintaining safe practice.

The transfusion of blood and blood products remains a highly effective and potentially life-saving treatment for many patients. However, blood is a living tissue and its transfusion, from one individual to another, is not without risk. Significant among these risks is the potential for human error and the subsequent transfusion of the incorrect blood component.

Antihypertensive treatment and the J-curve.

Unlike the brain, oxygen extraction for the heart is almost maximal at rest, so lowering coronary filling pressure (DBP) below the lower limit of autoregulation with antihypertensive drugs can lead to myocardial ischemia. This situation is exacerbated by the presence of coronary stenosis, which if more than 85% means that coronary flow reserve is virtually zero (particularly in the presence of LVH). Such patients experience a fall in coronary flow and ischemia when DBP is acutely lowered to less than the mid-80s.

Temporal relation between blood pressure and serum creatinine in young adults from a biracial community: the Bogalusa Heart Study.

It is well recognized that end-stage renal disease (ESRD) is associated with accelerated and malignant hypertension. The association of renal disease and what is considered as normal blood pressure is still not clear. The present study examined the temporal relation between blood pressure and renal function reflected by serum creatinine in a biracial (black-white) community-based population enrolled in the Bogalusa Heart Study.

Underreporting of energy intake in four populations of African origin.

Objective: To investigate the frequency of dietary underreporting in four African populations in different geographic and cultural settings.

Subjects: Seven-hundred and forty three men and women from rural Cameroon, 1042 men and women from urban Cameroon, 857 men and women from Jamaica and 243 male and female African Caribbeans from the UK. Subjects who reported dieting or weight control were excluded.

New approaches to the uses of beta blocking drugs in hypertension.

After a slow start, beta-blockers have become widely used as first-line agents in the treatment of hypertension, and recommended as such in recently published guidelines. There is evidence that the beta1-selective agents are more efficacious than non-selective blockers that inhibit both beta1 and beta2 receptors. Notwithstanding some earlier evidence to the contrary, it appears that beta1-selective drugs are equi-effective in young and elderly whites, younger, ie, under mid 60s, blacks.

Two domains of the epstein-barr virus origin DNA-binding protein, EBNA1, orchestrate sequence-specific DNA binding.

The EBNA1 (for Epstein-Barr nuclear antigen 1) protein of Epstein-Barr virus governs the replication and partitioning of the viral genomes during latent infection by binding to specific recognition sites in the viral origin of DNA replication. The crystal structure of the DNA binding portion of the EBNA1 protein revealed that this region comprises two structural motifs; a core domain, which mediates protein dimerization and is structurally homologous to the DNA binding domain of the papillomavirus E2 protein, and a flanking domain, which mediated all the observed sequence-specific contacts. To test the possibility that the EBNA1 core domain plays a role in sequence-specific DNA binding not revealed in the crystal structure, we examined the effects of point mutations in potential hydrogen bond donors located in an alpha-helix of the EBNA1 core domain whose structural homologue in E2 mediates sequence-specific DNA binding.

The habitual diet in rural and urban Cameroon.

Objective: To evaluate the habitual diet of a rural and urban population in Cameroon, Central Africa.

Setting: An urban area-Cité Verte Housing District, Yaoundé (1058 subjects); and a rural area-three villages in Evodoula, Cameroon (746 subjects).

Subjects: Cameroonian men and women of African origin (1058 urban, and 746 rural), aged 24-74 y.

Diabetes in the Caribbean: results of a population survey from Spanish Town, Jamaica.

Aims: To characterize the prevalence of diabetes and associated risk attributes in the Jamaican population.

Methods: A random population sample was recruited by door-to-door canvassing (n = 1303). A final participation of 60% was achieved.

Prevalence of diabetes and impaired glucose tolerance in Nigerians, Jamaicans and US blacks.

The prevalence of type 2 diabetes, impaired glucose tolerance and associated risk factors were compared in sample surveys in Africa and the Caribbean with the Third National Health and Nutrition Survey (NHANES-III) from the United States. A total of 856 Nigerians, 1286 Jamaicans, and 1827 US blacks were included in the study. Body mass index (BMI) increased in a stepwise fashion across the three populations groups, ie, 23 kg/m2 in Nigerians, 26 kg/m2 in Jamaicans, and 28 kg/m2 in US blacks.

Immediate management of acute severe asthma in adults.

Asthma is a disease with an increasingly high incidence in the UK, tragically accounting for almost 2000 UK deaths per year (Jones and Morris, 1997). Acute severe asthma is potentially life-threatening, necessitating immediate assessment and management. This article covers the main types of asthma, the pathophysiology of asthma, and the principles and rationale for the immediate management of adults admitted to the accident and emergency department suffering from an acute severe asthma attack.

Standardized comparison of glucose intolerance in west African-origin populations of rural and urban Cameroon, Jamaica, and Caribbean migrants to Britain.

Objective: To compare the prevalence of glucose intolerance in genetically similar African-origin populations within Cameroon and from Jamaica and Britain.

Research Design And Methods: Subjects studied were from rural and urban Cameroon or from Jamaica, or were Caribbean migrants, mainly Jamaican, living in Manchester, England. Sampling bases included a local census of adults aged 25-74 years in Cameroon, districts statistically representative in Jamaica, and population registers in Manchester.

Prevalence of anxiety and depressive illness and help seeking behaviour in African Caribbeans and white Europeans: two phase general population survey.

Objective: To determine the prevalence of common mental disorders (anxiety and depression) and help seeking behaviour in African Caribbeans and white Europeans.

Design: Two phase survey in a general population sample. The first phase comprised screening with the 12 item general health questionnaire; the second phase was standardised psychiatric assessment and interview about help seeking.

Barbados Low Dose Aspirin Study in Pregnancy (BLASP): a randomised trial for the prevention of pre-eclampsia and its complications.

Objective: To determine whether prophylactic, low dose controlled-release aspirin improves outcome for pregnant women and their babies in Barbados.

Design: Randomised placebo-controlled trial.

Setting: The Queen Elizabeth Hospital, Barbados.

T-cell receptor variable alpha (TCRAV) polymorphisms in European, Chinese, South American, AfroCaribbean, and Gambian populations.

Interactions involving the T-cell receptor (TCR) and major histocompatibility complex (MHC) are fundamental to the generation of a specific immune response. The study of interpopulation differences in TCR genes may identify those genes which are subject to selection, and also provides useful information for future genetic studies in these populations. In this study we present analysis of five TCRAV polymorphisms, for V5S1, V6S1, V8S1, V17S1, and V21S1 loci in five human populations by single-strand conformational polymorphism (SSCP) analysis.

Prevalence of NIDDM among populations of the African diaspora.

Objective: Rates of non-insulin-dependent diabetes mellitus have risen sharply in recent years among blacks in the U.S. and the U.

Development of food frequency questionnaires in three population samples of African origin from Cameroon, Jamaica and Caribbean migrants to the UK.

Objectives: To develop the methods for assessment of food and nutrient intake using standardized food frequency questionnaires (FFQ) in three African origin populations from Cameroon, Jamaica and Caribbean migrants to the United Kingdom.

Design: Cross-sectional assessment of diet from a representative sample in each site, using either a 2-day food diary or a 24-h recall method to determine foods for inclusion on the food frequency questionnaire.

Setting: A rural and urban site in Cameroon, Evodoula and Cite Verte in Yaounde, respectively; a district in Kingston Jamaica; African-Caribbeans living in central Manchester, UK.

A comparative study of hypertension prevalence, awareness, treatment and control rates in St Lucia, Jamaica and Barbados.

Background: Cardiovascular diseases represent the most common cause of death in the English-speaking Caribbean, and hypertension represents the most important predisposing condition. However, direct between-country comparative studies in the Caribbean have not previously been undertaken.

Objective: To obtain estimates of hypertension prevalence, awareness, treatment and control in three countries in the Caribbean.