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Biomedical subjects

D R Labarthe

Publications and source records attributed to D R Labarthe.

At least 55 records · Page 3Linked to original sources

Mortality after hospitalization for myocardial infarction among Mexican Americans and non-Hispanic whites: the Corpus Christi Heart Project.

We compared short- and long-term mortality among 334 Mexican Americans and 348 non-Hispanic whites hospitalized for myocardial infarction in the Corpus Christi Heart Project. Age-adjusted 28-day case fatality rates were 37% and 68% greater among Mexican-American women (6.7%) and men (6.2%) than among their non-Hispanic white counterparts (4.9% and 3.7%). Age-adjusted all-cause mortality rates over the next 25-month period, among those who survived the initial 28 days, were similar among Mexican-American and non-Hispanic white women (17.8% and 18.1%), but were 70% higher among Mexican-American men than among non-Hispanic white men (17.4% and 10.2%, respectively). Age-adjusted 25-month coronary mortality rates among initial 28-day survivors were 40% greater among Mexican-American women than among non-Hispanic white women (12.5% vs 9.0%), and 129% greater among Mexican-American men than among non-Hispanic white men (11.4% vs 5.0%, respectively). Thus, nearly all measures of post-myocardial infarction mortality indicated a survival disadvantage for Mexican Americans compared to non-Hispanic whites.

Adult↗

Acute myocardial infarction and coronary heart disease mortality among Mexican Americans and non-Hispanic whites in Texas, 1980 through 1989.

We calculated acute myocardial infarction and chronic coronary heart disease mortality rates for Mexican Americans and non-Hispanic whites in Texas for the 10-year period from 1980 through 1989 in an examination of ethnicity-related differences in death rates and trends according to vital statistics for the state of Texas. During the study period, acute myocardial infarction mortality decreased significantly in all four sex-ethnic groups, between 5.1% and 7.4% per year. Chronic coronary heart disease mortality rates decreased less, but significantly, for women in both ethnic groups, decreasing 3.4% and 1.8% per year for Mexican-American and non-Hispanic white women, respectively. We found no significant trend of changes in chronic coronary heart disease mortality rate among men in either ethnic group. For both acute myocardial infarction and chronic coronary heart disease mortality, rates were significantly lower among Mexican-American men than among non-Hispanic white men. Age-adjusted rate ratios for Mexican-American men in relation to non-Hispanic white men were 0.78 (95% CI: 0.65-0.93) and 0.75 (0.65-0.86) for acute myocardial infarction and chronic coronary heart disease mortality, respectively. No significant ethnicity-related mortality difference was seen among women. This previously observed interaction of ethnicity and sex in relation to coronary heart disease mortality remains unexplained. Despite apparently adverse cardiovascular risk factor profiles, Mexican Americans have acute myocardial infarction and chronic coronary heart disease mortality rates equal to or lower than their non-Hispanic white counterparts on the basis of death certificate data. This paradox deserves further attention.

Chronic Disease↗

The Blood Pressure Study in Mexican Children (BPSMC): I. Distribution and correlates of blood pressure in adolescent Mexican girls.

Blood pressure rises in adolescence and its increase appears to be more closely related to body size than to age. This cross-sectional study assessed the relationship between selected anthropometric and demographic factors and blood pressure during early adolescence in a sample of 233 females aged 10-12 years enrolled in public and private primary schools in Tlalpan, Mexico. Standardized measurements of blood pressure, arm circumference and length, height, weight, body mass index, and triceps skinfold were obtained. All anthropometric attributes were strong univariate correlates of blood pressure. Multiple regression analyses suggest positive associations between both body mass index and arm length and systolic blood pressure early in adolescence. When cross-cultural comparisons were made of blood pressure levels in the Blood Pressure Study in Mexican Children (BPSMC) with results in other countries, the BPSMC mean blood pressure levels were found to be the lowest. Possible explanations are discussed.

Adolescent↗

National standards of blood pressure for children and adolescents in Spain: international comparisons. The Spanish Group for the Study of Cardiovascular Risk Factors in Childhood and Youth.

This study determined age-specific patterns of blood pressure (BP) in Spanish children aged 1-18 years for the purpose of developing BP guidelines for this population. Age- and sex-specific BP levels were constructed by pooling data from 15 studies conducted in Spain. Pooled mean BP levels were then compared with those reported by the US Second Task Force on Blood Pressure Control in Children and those recently reported from a separate pooled analysis of the relevant published surveys collected worldwide. In the Spanish data, the average 1-year age increment in Systolic BP (SBP) was uniform for boys and girls until 13 years at 2 mmHg; for boys aged 13-18 the increase was 1.3 mmHg/year; in contrast, girls reached their maximum values at age 13 and the means remained basically unchanged for female adolescents. Fifth-phase diastolic BP (DBP5) values showed a uniform increase for both boys and girls from ages 6 to 18 years at 0.9 mmHg/year. In most age-sex subgroups, mean SBP values were higher (7-8 mmHg on average) in Spain than in the US. However, Spanish values for SBP were in general only slightly higher or approximately equal to those for the international data, from ages 6 to 18 years. The patterns of change in SBP with age differed somewhat in the three data sets. Comparisons for DBP were limited to the age groups for which readings of DBP5 were available. For DBP5, only slight differences between the Spanish and International pools were observed (ages 6-18 compared), but these values were notably higher than those from the US (ages 13-18 compared). These findings suggest that the use of any particular age-based standard to evaluate readings in children in diverse populations cannot be recommended, at least until there is a better understanding of the true differences in BP between populations.

Adolescent↗

Blood pressure and obesity in childhood and adolescence. Epidemiologic aspects.

Blood pressure and body mass index (BMI) are first considered independently, and then jointly, on the basis of both cross-sectional and longitudinal epidemiologic studies. The relations between these two attributes are investigated further by analysis of the "velocity curves" of age increments, from ages 6 to 24, in both blood pressure (systolic and fifth-phase diastolic) and BMI, from data from the US Health and Nutrition Examination Survey, 1971-1974. The results of both reported studies and the present exploratory analysis indicate sometimes strong but quite variable relations between blood pressure and BMI, which differ by age, gender, and the particular blood pressure measure under consideration.

Adolescent↗

Cholesterol screening in pediatric practice.

Four pediatricians introduced a portable cholesterol analyzer into their group practice. Their experience is described on the basis of 12 months of screening in 1665 children and adolescents. The overall 50th and 90th percentile values for a subgroup of 1406 routinely screened children were 156 and 197 mg/dL, respectively, but there was marked variation in these values among specific age and sex groups. Cholesterol levels decreased by age group during the early teenage years and increased thereafter, these changes occurring at ages approximately 2 years younger for girls than for boys. Further analysis of screening results for 398 sibling pairs demonstrated significant concordance between paired cholesterol levels when classified by the respective age- and sex-specific 90th percentile values for each member of the pair. Sibling pairs in which both members' cholesterol values exceeded their 90th percentile value were identified 2.4 times as frequently as expected (confidence interval 1.1 to 4.5, P = .029). The observations reported here indicate that office-based cholesterol screening in a pediatric practice may be both practical and useful, although further consideration of screening criteria is needed. Age- and sex-specific reference values for cholesterol levels during childhood could improve screening results. Special emphasis should be directed toward screening siblings of children in whom high cholesterol levels have been detected.

Adolescent↗

Japan: perspectives in school health.

In Japan, the original Law of School Health was established some 65 years ago to improve the environment and to prevent infectious diseases in school. Most recently, new environmental problems and behavioral issues have emerged. In addition to environmental health and health education, a major aspect of school health has been the development of a mass screening system both to detect present problems and to prevent adult diseases. In this article, the school health system in Japan is described and the application of mass screening by reference to heart disease as detected in Shimane Prefecture is illustrated. In the future, mass screening may be combined with a computer-based analysis system for managing data on new kinds of problems. New disciplines may become involved and improved programs developed, based on the lessons already learned from mass screening.

Delivery of Health Care↗

Intake and food sources of dietary fat among schoolchildren in The Woodlands, Texas.

To investigate the nutrient intake and food use patterns among schoolchildren, diet was assessed among 138 children and adolescents in grades 5 through 12 using three random, nonconsecutive, 1-day food records. Mean intake of total fat, saturated fat, and polyunsaturated fat as percent of calories was 35.6%, 13.4%, and 6.6%, respectively. Among all subjects, 17% consumed diets containing less than 30% of calories from fat, 34% consumed greater than or equal to 38% of calories from fat, 7% consumed less than 10% of calories from saturated fatty acids, and greater than 97% ate less than 300 mg of cholesterol per day. While intake of calories, sodium, and beta-carotene per 1000 kcal was higher in subjects consuming higher fat diets, intake of other micronutrients was either higher among those eating low-fat diets or did not differ by level of fat intake. Differences were seen in the amount of saturated fat and cholesterol that individual food sources contributed to the diets of subjects eating high and low fat diets. These cross-sectional data show that a substantial proportion of children and adolescents in this population are consuming diets low in fat and cholesterol without systematic differences in intake of other nutrients, suggesting that current dietary guidelines regarding fat intake are attainable within the current food use pattern of healthy, school-aged children and adolescents.

Adolescent↗

Environmental exposures in cytogenetically defined subsets of acute nonlymphocytic leukemia.

Three previous investigations have reported a relationship between clonal chromosome abnormalities in marrow of patients with acute nonlymphocytic leukemia and employment in occupations involving mutagenic chemicals, but the effects of other exposures were not described. Environmental exposure profiles, gathered by questionnaire, were therefore compared using a case-control study design in 235 newly diagnosed patients with acute nonlymphocytic leukemia: 126 with abnormal and 109 with normal karyotypes. The univariate odds ratio for occupation at diagnosis was 4.6, which, when adjusted for demographic and other exposures by logistic regression, was reduced to 2.5 (95% confidence interval, 0.5 to 12.8). Adjusted point estimates for other exposures were 4.3 (1.4 to 13.3) for prior cytotoxic therapy, 1.7 (0.9 to 3.1) for cigarette smoking, and 1.9 (1.0 to 3.4) for alcohol use. Dose-response relationships were present for both tobacco and alcohol consumption. Associations between specific abnormalities (+8, -7I-7q, [corrected] inv16, t[8;21]) and certain exposures were also present. These results suggest that life-style exposures may be associated with cytogenetic lesions in persons with acute nonlymphocytic leukemia.

Alcohol Drinking↗

Blood pressure by age in childhood and adolescence: a review of 129 surveys worldwide.

The pre-adult patterns of change in blood pressure with age have been investigated by review and pooled analysis of the relevant worldwide literature. The results indicate, foremost, the almost universal overall upward progression of blood pressure levels between ages 6 and 18 years, separately for systolic, fourth-phase and fifth-phase diastolic pressures (SBP, DBP4, DBP5). This report summarizes results of an extensive literature search based on 129 qualifying publications, in many languages, of which 79 yielded data adequate for a pooled age-sex-specific analysis for boys and girls aged 6-18 years. More than 200,000 observations were available for SBP and nearly 100,000 each for DBP4 and DBP5, respectively. In this overall pool, SBP increased uniformly for boys from age 6-12 and for girls from 6-9, at 1.4 mm Hg/yr; for boys the slope increased abruptly to 3.2 mm Hg/yr from 12-15 and fell to 0 at age 18; for girls the maximum increase was only 2.1 mm Hg/yr, from 9-13, and it reversed at age 16, reaching -3.4 mm Hg/yr from 17-18. Thus for SBP the absolute values for boys and girls were identical up to age nine and nearly so to age 14 and then separated, with values for girls increasing only slightly to age 16 and actually decreasing to age 18. A similar separation of age-specific values by sex occurred with DBP4, but not until age 16, after which DBP4 decreased for girls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗