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101.
Background Gastric bypass surgery for morbid obesity has dramatically increased in volume over the past decade. Caucasian patients have
been noted previously to lose more weight after bariatric surgery than African-Americans patients. Data regarding predictors
of maintaining weight loss after surgery are minimal. We sought to determine predictors of long-term weight loss after bariatric
surgery.
Methods Retrospective analysis using a multivariate logistic regression model of all patients undergoing Roux-en-Y gastric bypass
surgery at the Medical University of South Carolina from May 1993 to December 2004 for whom 2 years of follow-up data was
available. Our dependent variable was the percentage of weight lost from baseline, dichotomized at ±35%. Our primary independent
variable was race, defined as Caucasian, African-American, or other. Relevant covariates were added to the model to control
for their potential effects on outcome.
Results One hundred eleven patients (17 male/94 female; 85% Caucasian, mean age 44 years (range 18–68 years). In our model, Caucasian
subjects (adjusted odds ratio [OR] = 7.60, 95% confidence intervals [95%CI] = 1.83–31.5) and late post surgical complications
(adjusted OR = 2.67, 95%CI = 1.05–6.80) significantly predicted weight loss at 2 years, after controlling for relevant confounders.
Other covariates did not significantly impact the model.
Conclusion Race and late post surgical complications significantly impacted the percentage of weight loss at 2 years for patients undergoing
Roux-en-Y gastric bypass surgery at our institution. Future research should be directed at determining potential genetic and/or
social reasons for these differences. 相似文献
102.
Zhan M Flaws JA Gallicchio L Tkaczuk K Lewis LM Royak-Schaler R 《Cancer Detection and Prevention》2007,31(5):384-390
Background: Tamoxifen (TAM) is a selective estrogen receptor modulator (SERM) that is widely used as adjuvant therapy in breast cancer patients; however, it is also associated with undesirable side effects. The goal of this study was to investigate TAM-related side effects, and determine profiles of side effects by race and by smoking status. Methods: A secondary data analysis was conducted using cross-sectional study data from 138 African American and Caucasian women with breast cancer taking TAM 20 mg daily for at least 30 days prior to enrollment. Participants completed questionnaires that obtained information about demographic characteristics, reproductive history, health and lifestyle characteristics, TAM use and its related side effects. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals. Results: Compared to never smokers, a significantly greater percentage of current smokers reported ever experiencing TAM-related nausea (28.0% versus 5.0%, P = 0.007), depression (40.0% versus 7.1%, P = 0.001) and migraines (19.2% versus 1.7%, P = 0.02). These differences remained statistically significant after controlling for race, age, obesity, tumor stage, and duration of TAM treatment. No significant differences by race were noted in women reporting TAM side effects. Conclusion: The findings from this study suggest that current smokers with breast cancer should be informed of the increased probability of reporting TAM-related side effects such as nausea, depression and migraines, and counseled about smoking cessation which may reduce the incidence of these side effects. 相似文献
103.
104.
T. G. Travison T. J. Beck G. R. Esche A. B. Araujo J. B. McKinlay 《Osteoporosis international》2008,19(3):277-287
Summary Data on bone architecture in diverse male populations are limited. We examined proximal femur geometry in 1,190 black, Hispanic,
and white men. Cross-sectional analyses indicate greatest bone strength among black men, and greater age-related differences
in bone strength among Hispanic men than other subjects at the narrow neck and intertrochanter regions of the proximal femur.
Introduction Although race/ethnic differences in bone mass are well-documented, less is known about differences in bone architecture. We
examined proximal femur geometry in a diverse, randomly-sampled population of 1,190 community-dwelling men (age 30–79 y).
Methods Dual X-ray absorptiometry scans were obtained for 355 black, 394 Hispanic, and 441 white subjects. Measures were obtained
for the narrow neck (NN), intertrochanter (IT) and shaft regions of the proximal femur via hip structural analysis. Analyses
considered bone mineral density (BMD, g/cm2), outer diameter (cm), cross-sectional area (CSA, cm2), section modulus (Z, cm3), and buckling ratio (BR). Results were adjusted for height, weight and physical activity level.
Results Black subjects exhibited greater age-specific BMD, CSA and Z, than their white counterparts. For instance, at age 50 y, NN
BMD was approximately 11% higher among black men (p < 0.001). Hispanic men exhibited sharper age-related differences in NN and IT BMD than did others. IT BMD, for instance,
decreased by 2.4% with 10 y age among Hispanic subjects, but had virtually no age trend in others (p < 0.001).
Conclusions These results imply greater bone strength among black American men than among their white counterparts, and may indicate elevated
fracture risk among older Hispanic American subpopulations.
Grant support: The BACH/Bone study was supported by grant AG 20727 from the National Institute on Aging (NIA). The parent
study (BACH) was supported by grant DK 56842 from the National Institute of Diabetes and Digestive and Kidney Diseases. 相似文献
105.
Hand Movement Speed and Accuracy in Detoxified Alcoholics 总被引:1,自引:0,他引:1
Detoxified alcoholics (n = 192) were found to be 9.3% slower than age-matched controls (n = 112) with regard to the composite speed (movement time, MT) with which they were able to strike targets of various sizes and distances with a hand-held stylus at onset of a light stimulus (Fitts's Task). Females (n = 102) were 8% slower than males (n = 202), and blacks (n = 103) about 15.6% slower than whites (n = 201). Gender was the only significant factor with regard to errors (target misses), with women committing 28% fewer errors than men. Women, in contrast to men, appear to trade speed for accuracy in this task. Favorable socioeconomic/medical status and target misses were directly related to movement speed. Thus, when the MT data were corrected for lifestyle variables, the significance of the alcohol effects on MT disappeared, but gender differences persisted. The alcohol effect became statistically significant, the ethnic group differences remained statistically significant, and the gender effect became insignificant when MT scores were corrected for accuracy of performance (target misses). The slope of the linear function relating MT to target difficulty was similar for all subgroups. Prior knowledge of the direction of movement was found to affect MT performance more in white than in black subjects. With regard to reaction times, ethnic group and alcohol use effects remained statistically significant after corrections for lifestyle and errors were made, with values for blacks about 5% slower than values for whites, and values for alcoholics about 4.6% slower than those for controls. Prior knowledge of the direction of movement significantly improved (shortened) reaction time in all subgroups (14%-19%). 相似文献
106.
H. A. Bischoff-Ferrari J. E. Orav J. A. Barrett J. A. Baron 《Osteoporosis international》2007,18(9):1225-1233
Summary In this large population-based study, fracture rates for hips, distal forearms, proximal humeri, and ankles were higher in
winter than in other seasons, although the winter peak was small for hip fractures (p < 0.05 at all sites). Younger age between
65 and 80, living in warmer states and male gender were associated with increased winter morbidity due to fractures.
Introduction The objective was to investigate seasonal variation in the incidence of four common fractures, and explore the association
of weather with risk.
Methods Population-based analysis of individuals age 65 and older, including fractures of the hip, the distal forearm, the proximal
humerus and the ankle. Weather information was obtained from the US National Oceanic and Atmospheric Administration website.
Results For all fractures, rates were highest in winter and lowest in summer (p < 0.05 at all sites). Winter peaks were more pronounced
in warm climate states, in men, and in those younger than 80 years old. In winter, total snowfall was associated with a reduced
risk of hip fracture (−5% per 20 inches) but an increased risk of non-hip fractures (6–12%; p < 0.05 at all sites). In summer,
hip fracture risk tended to be lower during sunny weather (− 3% per 2 weeks of sunny days; p = 0.13), while other fractures
were increased (15%–20%; p < 0.05) in sunny weather.
Conclusion Fractures contribute considerably to winter morbidity in older individuals. Younger age between 65 and 80, living in warmer
states and male gender are risk factors for increased winter morbidity due to fractures. Weather affects hip fracture risk
differently than the other fractures studied.
Funding Supported by fellowships from the Harvard Hartford Foundation, from the Swiss Foundation for Nutrition Research, and the International
Foundation for the Promotion of Nutrition Research and Nutrition Education. 相似文献
107.
108.
Despite the health and survival advantages of Hispanics relative to non-Hispanic whites in the USA, Hispanics report themselves to be in worse health than whites. Prior research indicates that these ethnic differences in self-rated health (SRH), measured by a simple question asking individuals to assess their overall health status, persist in the presence of an extensive set of explanatory variables. In this paper we use data from the first wave of the Los Angeles Family and Neighborhood Survey (L.A.FANS-1) to test three hypotheses regarding Hispanic-white differences in SRH. We evaluate whether poorer health reports among Hispanics result from: (1) acculturation and language-related differences in reports; (2) measures of socioeconomic status (SES) that are often omitted in other studies; and (3) somatization of emotional distress by Hispanics. Our results provide new insights into the validity of these explanations and suggest avenues for future research. First, they underscore the importance of language of interview over other measures of acculturation, suggesting that translation issues between the Spanish and English versions of the SRH question may give rise to some of the differences. Second, adjustment for SES - especially years of schooling - narrows, but does not eliminate, the gap between whites' and Hispanics' SRH. Finally, although respondents who are depressed are more likely to report poor SRH, this study provides little evidence to support the somatization hypothesis. The second wave of L.A.FANS incorporates new questions that are likely to permit more in-depth assessments of these hypotheses in future analyses. 相似文献
109.
Alegria M Shrout PE Woo M Guarnaccia P Sribney W Vila D Polo A Cao Z Mulvaney-Day N Torres M Canino G 《Social science & medicine (1982)》2007,65(2):214-230
This study seeks to identify risk factors for psychiatric disorders that may explain differences in nativity effects among adult Latinos in the USA. We evaluate whether factors related to the processes of acculturation and enculturation, immigration factors, family stressors and supports, contextual factors, and social status in the US account for differences in 12-month prevalence of psychiatric disorders for eight subgroups of Latinos. We report results that differentiate Latino respondents by country of origin and age at immigration (whether they were US-born or arrived before age 6: In-US-as-Child [IUSC]; or whether they arrived after age 6: later-arrival immigrants [LAI]). After age and gender adjustments, LAI Mexicans and IUSC Cubans reported a significantly lower prevalence of depressive disorders than IUSC Mexicans. Once we adjust for differences in family stressors, contextual factors and social status factors, these differences are no longer significant. The risk for anxiety disorders appears no different for LAI compared to IUSC Latinos, after age and gender adjustments. For substance use disorders, family factors do not offset the elevated risk of early exposure to neighborhood disadvantage, but coming to the US after age 25 does offset it. Family conflict and burden were consistently related to the risk of mood disorders. Our findings suggest that successful adaptation into the US is a multidimensional process that includes maintenance of family harmony, integration in advantageous US neighborhoods, and positive perceptions of social standing. Our results uncover that nativity may be a less important independent risk factor for current psychiatric morbidity than originally thought. 相似文献
110.
Neighborhood economic disadvantage, violent crime, group density, and pregnancy outcomes in a diverse, urban population 总被引:1,自引:1,他引:0
Prior research has established associations between pregnancy outcomes and specific neighborhood characteristics, including economic disadvantage, violent crime, and racial/ethnic segregation. Recently, associations have also been found between various health outcomes and group density, the degree to which an individual is a racial or ethnic majority in his or her local community. The objective of this study was to determine the extent to which census tract economic disadvantage, violent crime rate, and group density are associated with pregnancy outcomes among White, Black, and Hispanic infants in a large metropolitan setting. This cross-sectional study utilized 1990 census data, 1991 crime data, and 1991 birth certificate information for singleton live births in Chicago, Illinois. Results show substantial racial segregation in Chicago, with 35% of census tracts having more than 90% Black residents and 45% of census tracts having fewer than 10% Black residents. After stratifying by maternal race/ethnicity, we used multilevel analyses to model pregnancy outcomes as a function of individual and census tract characteristics. Among all racial/ethnic groups, violent crime rate accounted for most of the negative association between tract economic disadvantage and birth weight. Group density was also associated with birth weight but this association was stronger among Whites and Hispanics than among Blacks. Further analysis revealed that group density was more strongly associated with preterm birth while violent crime rate was more strongly associated with small for gestational age. These results suggest that group density and violent crime may impact birth weight via different mechanisms. 相似文献