Role of endocrinologists in eliminating health care disparities.

Objective: To review some of the persistent disparities in health and health care in the United States related to race, ethnicity, and socioeconomic status, with a focus on diabetes mellitus and obesity, and to discuss the role of endocrinologists in preventing these disparities.

Methods: Some of the efforts made by the US government, such as public health strategies, to address health disparities are outlined, and statistics about diabetes and obesity are presented.

Results: The elimination of health disparities, recognized as a national challenge for decades, is a national priority as defined in the national goals for Healthy People 2010.

The increasing impact of arthritis on public health.

Age is the most powerful risk factor for osteoarthritis (OA) in the United States. It is estimated that 68% of individuals older than 55 years have radiographic evidence of OA. The US is growing older--the over-65 age group represented only 4% of the population in 1900, but accounted for 12.

The report of the Surgeon General: preventing tobacco use among young people.

This year's surgeon general's report on smoking and health is the first such report to focus on young people. From extensive data that indicate that tobacco use is a pediatric epidemic, the report reached six major conclusions: (1) Nearly all first use of tobacco occurs by age 18. (2) Most adolescent smokers are addicted to nicotine.

School-based clinics and the pediatric nurse: an interview with Surgeon General designee M. Joycelyn Elders. Interview by Judith E. Vessey and Margo N. Swanson.

Among Dr. Joycelyn Elders' goals as Surgeon General is to work toward a national school-based clinic program. In this interview, she speaks with Pediatric Nursing regarding the implementation of school-based clinics in Arkansas, arguments for and against school-based clinics, the financial responsibility for these clinics, and the role of pediatric nurses in this segment of health care reform.

Portrait of inequality.

America's children are stalked by race- and income-based inequities that demand our attention. Health care reform efforts that respect the needs of the entire child can diminish these inequities. Six prescriptions will help: universal early childhood education; comprehensive health and family life education; parental support; reinforcement of male responsibility; comprehensive school-based clinics; and opportunities for higher education.

Glomerulopathy in patient with Donohue syndrome (leprechaunism).

Objective: To evaluate renal structure in a child with Donohue syndrome (leprechaunism), who at 10 yr of age was noted to have hypertension, microalbuminuria, and enlarged kidneys, a renal biopsy was performed.

Research Design And Methods: The renal biopsy tissue was evaluated by light and electron microscopy with standard stereological techniques to measure glomerular volume, glomerular basement membrane width, fractional mesangial volume, and peripheral capillary filtering surface density.

Results: On renal biopsy, there was a marked increase in glomerular volume, glomerular basement width, and mesangial volume, findings similar to those seen in patients with diabetic nephropathy.

Hypertrophy of clitoral hood: presenting sign of neurofibromatosis in female child.

Although clitoral involvement with neurofibromatosis is rare, all cases previously reported have described clitoral hypertrophy due to neurofibromas of the clitoral corpora. We report on a patient who had localized enlargement of the prepuce only, with no evidence of neurofibromatous infiltration. In all cases, diagnosis of clitoromegaly requires basic chromosomal and endocrinologic evaluation.

Effects of dideoxyforskolin on proteoglycan synthesis and structure in embryonic chick chondrocyte cultures.

1,9-Dideoxyforskolin inhibits proteoglycan synthesis and xyloside-initiated glycosaminoglycan (GAG) synthesis in chick embryo chondrocytes. Dideoxyforskolin does not affect the length of xyloside-initiated GAG chains secreted into the medium but chains from the dense proteoglycan secreted into the medium appear slightly longer. Incorporation of labeled serine into the dense proteoglycan and subsequent digestion with Pronase revealed a dramatic decrease in percent of total radioactivity associated with GAG chains in the proteoglycan from cultures treated with forskolin or dideoxyforskolin.

Effect of forskolin on synthesis of xyloside-initiated glycosaminoglycans in embryonic chick chondrocytes.

The synthesis of sulfated glycosaminoglycan (GAG) chains has been studied in the presence of various concentrations of the artificial acceptor 4-methylumbelliferyl beta-D-xyloside and of forskolin. Sulfated GAG chains formed in the presence of forskolin had a smaller hydrodynamic radius than controls, as revealed by chromatography on Sepharose CL-6B. Sulfated GAGs from both control and treated cultures behaved identically when chromatographed on DEAE.