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Biomedical subjects

C Blanton

Publications and source records attributed to C Blanton.

7 recordsLinked to original sources

Role of coronary interventional procedures in improved postinfarction survival in the 1990s.

The contribution of increased use of same-admission percutaneous coronary interventional procedures to recent improvements in hospital survival of patients with acute myocardial infarction (AMI) remains unclear. Patients with International Classification of Diseases codes for AMI (code 410), who were admitted to the emergency coronary care unit and underwent an initial episode of treatment, were studied over the 9-year period 1990 to 1998 (n = 2,628). Three triennia between 1990 and 1998 were compared. Trends in risk, the use of procedures, and hospital outcomes were analyzed. Hospital mortality was 33% lower (p <0.02) in the third triennium (5.8%) than in the earlier 2 triennia (8.7%), equivalent to an absolute reduction of 29 hospital deaths/1,000 patients treated. The lower hospital mortality was not due to: (1) shorter hospital stays (reduction in mortality was primarily in the first 3 hospital days), (2) treatment of lower risk subjects (a risk score based on age, gender, and presence of diabetes increased between the first and third triennia), or (3) use of in-hospital interventional procedures (although the use of percutaneous coronary intervention more than doubled in the third triennium, most procedures were performed in patients with a 1% risk of hospital death). We conclude from this study that there has been a substantial improvement over a 9-year period in early case fatality after AMI, but that this cannot be attributed to the increased use of in-hospital coronary interventions, which were largely performed on low-risk patients.

Aged↗

Measuring physical activity with the behavioral risk factor surveillance system.

PURPOSE AND METHODS: Because regular physical activity reduces the risk of premature death and disability, accurate methods of population-based measurement are important for public health surveillance efforts such as those based on the Behavioral Risk Factor Surveillance System (BRFSS). The present study: 1) briefly reviews and compares currently available methods to measure physical activity using BRFSS data, 2) describes physical activity patterns in the United States using these state-aggregated measures, and 3) provides suggestions on future directions for practitioners and researchers. Using a random-digit dialing, telephone survey, we collected data for noninstitutionalized adults aged 18 yr and older. We analyzed BRFSS data for 1996 from 50 states and the District of Columbia and Puerto Rico (N = 124,085). Based on recent literature and public health priorities, we developed eight different physical activity indices (one vigorous and seven moderate). These varied in their threshold for duration, kcal expenditure, and in frequency and intensity of activity. RESULTS: Using different algorithms, the population prevalence of moderate physical activity ranged from about 20% to 38%. Only 20% of adults met the Healthy People 2000 definition for regular, sustained activity (> or =30 min of moderate activity per day for at least 5 d x wk(-1)). CONCLUSIONS: Considerable progress is needed if the United States is to reach the current public health goal for regular physical activity. Standardized approaches to analyzing and collecting physical activity data are essential for public health surveillance, policy making, and communication to the public.

Adolescent↗

Tobacco use by youth: a surveillance report from the Global Youth Tobacco Survey project.

The Global Youth Tobacco Survey (GYTS) project was developed by the World Health Organization and the US Centers for Disease Control and Prevention to track tobacco use among youth in countries across the world, using a common methodology and core questionnaire. The GYTS is school based and employs a two-stage sample design to produce representative data on smoking among students aged 13-15 years. The first stage consists of a probabilistic selection of schools, and the second consists of a random selection of classes from the participating schools. All students in the selected classes are eligible for the survey. In 1999, the GYTS was conducted in 13 countries and is currently in progress in over 30 countries. This report describes data from 12 countries: Barbados, China, Costa Rica, Fiji, Jordan, Poland, the Russian Federation (Moscow), South Africa, Sri Lanka, Ukraine (Kiev), Venezuela, and Zimbabwe. The findings show that tobacco use in the surveyed age group ranged from a high of 33% to a low of 10%. While the majority of current smokers wanted to stop smoking, very few were able to attend a cessation programme. In most countries the majority of young people reported seeing advertisements for cigarettes in media outlets, but anti-tobacco advertising was rare. The majority of young people reported being taught in school about the dangers of smoking. Environmental tobacco smoke exposure was very high in all countries. These results show that the GYTS surveillance system is enhancing the capacity of countries to design, implement, and evaluate tobacco prevention and control programmes.

Adolescent↗

Levels of physical activity and inactivity in children and adults in the United States: current evidence and research issues.

PURPOSE: The purpose was to describe current levels of physical activity and inactivity among adults and young people in the United States. METHODS: Estimates of participation in regular physical activity were derived from three national surveys for adults (National Health Interview Survey, National Health and Nutrition Examination Survey, and the Behavioral Risk Factor Surveillance System) and from the Youth Risk Behavior Survey for high school students. RESULTS: Overall, 63.8% of high school students surveyed on the 1997 YRBS reported participating in vigorous physical activity for at least 20 min on 3 or more days per week. Participation in vigorous activity was higher for boys (72.3%) than girls (53.5%), whites (66.8%) compared with blacks (53.9%) and Hispanics (60.4%), and decreased with advancing grade. Among adults, 27.7% meet recommended levels of either moderate or vigorous physical activity, whereas 29.2% report no regular physical activity outside of their work. Gender differences in participation in physical activity are less pronounced than in youth, and age-related patterns were complex. Whites are more active than blacks and Hispanics, and persons with higher family incomes and more education report being more physically active. There have been only minor changes in reported participation in leisure time physical activity over the past 15 yr. CONCLUSION: National estimates of physical activity appear to be reliable and valid for adults but may be less so for adolescents and are poor measures for children. Research is needed to determine the role that objective monitoring with accelerometers may play in surveillance. Reliable and valid measures of occupational, household, and transportation-related physical activity and sedentary behaviors are needed to better characterize the range of activity that is associated with health.

Adult↗

AIDS and intravenous drug use: a growing menace.

The AIDS virus is transmitted through the exchange of bodily fluids between an infected person and an uninfected person, and the sharing of needles by IV drug users has been one of the primary means of transmission. The incidence of infection by this method has increased in the world, and in the inner cities of the United States has been a particular problem. Infected drug users also transmit the disease to their sexual partners and to their unborn children. Educational efforts have been directed at changing the behavior of drug users to reduce their sharing of needles, and some cities have tried handing out free needles. Such efforts, of course, run counter to the admonition not to use drugs at all, but health professionals believe changing behavior is the most important way of attacking the disease. While transmission of the HIV virus through IV drug abuse remains a significant problem, there is evidence that the educational efforts have been working and that, in some areas at least, behaviors have been changed and the risk has been reduced.

Acquired Immunodeficiency Syndrome↗

Inexpensive quality television camera suitable for use with operating microscope.

Video monitoring and video recording are useful in ophthalmic microsurgery for self-instruction and improvement, increased interest by operating room personnel, transfer of useful information to other physicians and improvement of technique. Specialized video cameras for such use are expensive. There is, however, a newly-marketed, inexpensive and light-weight video camera, which was designed for electronic newsgathering purposes, and which can be modified for microsurgery application, providing excellent results.

Costs and Cost Analysis↗