Overt albuminuria predicts diabetic retinopathy in Hispanics with NIDDM

Non-insulin-dependent diabetes mellitus (NIDDM) occurs with a higher frequency in Hispanic as compared with non-Hispanic whites. It also appears that there is a higher prevalence of diabetic nephropathy in the Hispanic population when compared with non-Hispanic whites. In the current study, 144 Hispanics and 671 non-Hispanic white NIDDM subjects were studied to determine the possible association of various risk factors and diabetic complications, including overt albuminuria, with diabetic retinopathy. Stereoscopic retinal fundus photographs were obtained and graded by the University of Wisconsin Fundus Photographic Reading Center. We also sought to determine whether risk factors for retinopathy vary between Hispanics and non-Hispanic whites. In the total group, duration of diabetes, glycosylated hemoglobin, neuropathy, diastolic hypertension, use of insulin, and Hispanic ethnicity correlated with the presence of retinopathy. Controlling for severity and duration of diabetes, Hispanics had a significantly increased risk of retinopathy relative to non-Hispanic whites (OR = 2.13, 95% CI = 1.34, 3.37, P = 0.0013). Duration of diabetes and presence of neuropathy were significantly correlated with the presence of diabetic retinopathy in Hispanics and non-Hispanic whites. The presence of overt albuminuria (>200 microg/min), although not related to diabetic retinopathy in non-Hispanic whites, conferred a high risk for diabetic retinopathy in Hispanics (OR = 11.14, CI = 1.20, 103.39, P = 0.0339) independent of other risk factors. In summary, Hispanics with NIDDM have an increased prevalence of diabetic retinopathy when compared with non-Hispanic whites. In addition, overt albuminuria in the Hispanic subjects appears to be a powerful predictor of the diabetic retinopathy.     

Combating Syphilis and HIV Among Users of Internet Chatrooms

ABSTRACT

The recent resurgence of syphilis among men-who-have-sex-with-men (MSM) and concerns about a potential increase in HIV incidence have sparked public health authorities to search for new approaches to address this converging problem. Epidemiologic investigations suggest that the Internet plays an important role in facilitating syphilis outbreaks. The experience of this pilot will help the public health community learn more about how to reach targeted online audiences, and will contribute toward understanding the role of the Internet in risk reduction strategies aimed at persons who use the Internet to meet sex partners.     

Year one of HIV prevention community planning: a national perspective on accomplishments, challenges, and future directions.

Two of the most important principles for the implementation of successful human immunodeficiency virus (HIV) prevention programs are the following: (a) planning for the programs must be done in conjunction with members of affected communities; and (b) the foundation of the programs should consist of solid behavioral, social, and epidemiological science. In 1994, the Centers for Disease Control and Prevention and its prevention partners formally implemented HIV prevention community planning in order to address these two key factors. The occasion of the one year anniversary of HIV prevention community planning is marked by taking stock of progress-to-date from a national perspective. This article reviews year one accomplishments and difficulties, and describes the trajectory of HIV prevention community planning for year two and beyond.