Biomedical subjects

Lisa M Bodnar

Publications and source records attributed to Lisa M Bodnar.

23 records · Page 2Linked to original sources

PubMed2002

Who should be screened for postpartum anemia? An evaluation of current recommendations.

The authors evaluated the utility of selective screening criteria for postpartum anemia developed by the Centers for Disease Control and Prevention (CDC) versus criteria developed among low-income women using prevalence-based screening principles. Pregnant women in Raleigh, North Carolina, were followed up to the postpartum visit in 1997-1999 (n = 345). Prevalence of postpartum anemia was 19.1%. Independent risk markers, arrived at through multivariate logistic regression, were multiparity (odds ratio (OR) = 1.5, 95% confidence interval (CI): 0.8, 2.9), obesity (OR = 3.0, 95% CI: 1.6, 5.5), anemia at 24-29 weeks' gestation (OR = 2.3, 95% CI: 1.2, 4.4), anemia before delivery (OR = 3.4, 95% CI: 1.8, 6.7), and not exclusively breastfeeding (OR = 2.8, 95% CI: 1.0, 7.7). Risk scores were calculated by counting risk markers present. Likelihood ratios were determined for all possible risk scores of our algorithm and CDC's algorithm. Anemia screening decisions differed depending on clinic anemia prevalence. For example, if low test thresholds are assumed, when clinic prevalence is 10%, women with risk scores >3 on the authors' algorithm and >0 on CDC's algorithm should be screened. The authors' algorithm, in combination with prevalence information, can save clinics more money than CDC's current algorithm because a broader range of likelihood ratios was obtained, indicating a better ability to distinguish high- from low-risk women. However, if resources are available, universal screening should be considered in high-prevalence settings.

Adult↗

PubMed2002

What are pregnant women eating? Nutrient and food group differences by race.

OBJECTIVE: The purpose of this study was to identify foods that contributed most to nutrient and fiber intake in a sample of pregnant women in North Carolina. STUDY DESIGN: This was a prospective study of women in the Pregnancy, Infection, and Nutrition Study (n = 2247 women). Dietary information during the second trimester was collected with the use of a food frequency questionnaire. The contribution of each food item to the population's intake was calculated. RESULTS: Overall, low nutrient-dense foods were major contributors to energy, fat, and carbohydrates, whereas fortified foods were important sources of iron, folate, and vitamin C. The median energy intake for this population was 2478 kcal. The median dietary intakes of iron were below the recommended levels. Although black women consumed more calories on average, white women, after energy adjustment, consumed greater amounts of protein, iron, folate, and fiber. CONCLUSION: These data emphasize the importance of evaluating both the nutrient density in the diet and the frequency of consumption in the assessment of the diets of pregnant women.

Black or African American↗

PubMed2002

A Diet Quality Index for Pregnancy detects variation in diet and differences by sociodemographic factors.

OBJECTIVE: Methods currently used to assess nutritional status during pregnancy have limitations if one wishes to examine the overall quality of the diet. A Diet Quality Index for Pregnancy (DQI-P) was developed to reflect current nutritional recommendations for pregnancy and national dietary guidelines. DESIGN: Dietary intake was assessed during the second trimester using a food-frequency questionnaire. The DQI-P includes eight components: % recommended servings of grains, vegetables and fruits, % recommendations for folate, iron and calcium, % energy from fat, and meal/snack patterning score. Scores can range from 0 to 80; each component contributed 10 points. SETTING: Two public prenatal clinics in central North Carolina. SUBJECTS: N = 2063 pregnant women who participated in the Pregnancy, Infection, and Nutrition (PIN) Study. RESULTS: The DQI-P quantitatively differentiated diets. The mean score for the population was 56.0 (standard deviation 12.0). Women who were >30 years old, >350% of poverty, nulliparous and high school graduates had significantly higher overall DQI-P scores. Higher percentages of recommended vegetable servings were consumed by higher-income, older and better-educated women. Greater percentages of recommended intakes of folate and iron were seen among black, low-income and nulliparous women. Higher iron intakes were also seen among women who graduated high school and were less than 30 years old. Other differences were observed for intake of fat and meal/snack pattern. Because this index was based on national recommendations, the DQI-P may be a useful tool for research and public health settings to evaluating overall diet quality of pregnant women.

Adult↗

PubMed2002

Low income postpartum women are at risk of iron deficiency.

We estimated the prevalence of postpartum iron deficiency, anemia and iron deficiency anemia in the United States and compared risk of iron deficiency between women 0-24 mo postpartum (n = 680) and never-pregnant women, 20-40 y old (n = 587). We used data from National Health and Nutrition Examination Survey, 1988-1994. Iron deficiency was defined as abnormal values for > or = 2 of 3 iron status measures (serum ferritin, free erythrocyte protoporphyrin, transferrin saturation). Iron deficiency prevalences for women 0-6, 7-12 and 13-24 mo postpartum were 12.7, 12.4 and 7.8%, respectively, and 6.5% among never-pregnant women. After adjustment for confounding, the risk of iron deficiency among women with a poverty index ratio < or = 130% who were 0-6, 7-12 and 13-24 mo postpartum was 4.1 (95% confidence interval 2.0, 7.2), 3.1 (1.3, 6.5) and 2.0 (0.8, 4.1) times as great, respectively, as never-pregnant women with a poverty index ratio > 130%, but risk was not elevated for never-pregnant women with a poverty index ratio < or = 130%. Compared with the same referent, the risk of iron deficiency was not meaningfully different for women with a poverty index ratio > 130% who were 0-6, 7-12 or 13-24 mo postpartum. Given that low income postpartum women bear a substantially greater iron deficiency risk than never-pregnant women, more attention should be given to preventing iron deficiency among low income women during and after pregnancy.

Anemia, Iron-Deficiency↗

PubMedDate not supplied

Effect of concurrent radiation therapy and chemotherapy on pulmonary function in patients with esophageal cancer: dose-volume histogram analysis.

PURPOSE: The pulmonary effects of concurrent radiation therapy and chemotherapy were studied in patients enrolled in a phase I trial for esophageal cancer. MATERIALS AND METHODS: Pulmonary function tests were performed prospectively before and after combined-modality therapy (oxaliplatin, 5-fluorouracil, and radiation therapy) in 20 patients with esophageal cancer. Cumulative and differential lung DVH analysis from 0 to 5400 cGy in 25-cGy intervals was performed for the last 15 patients. Correlation between radiation exposure in various dose ranges and percent reduction in pulmonary function tests was calculated as an exploratory analysis. RESULTS: Significant reductions in carbon monoxide diffusion capacity corrected for hemoglobin (12.3%) and total lung capacity (2.5%) were evident at a median of 15.5 days after radiation therapy. DVH analysis revealed that the single dose of maximum correlation between lung volume radiation exposure and lung function reduction was less than 1000 cGy for all pulmonary functions. The percent lung volume that received a total dose between 700 and 1000 cGy maximally correlated with the percent reductions in total lung capacity and vital capacity, and the absolute lung volume that received a total dose between 700 and 1000 cGy maximally correlated with the percent reductions in total lung capacity, vital capacity, and carbon monoxide diffusion capacity. DISCUSSION: Significant declines in carbon monoxide diffusion capacity and total lung capacity are evident immediately after the administration of conformal radiation therapy, oxaliplatin, and 5-fluorouracil for esophageal cancer. Other lung functions remain statistically unchanged. The percent or absolute lung volume that received a total dose between 700 and 1000 cGy may be significantly correlated with the percent decline of carbon monoxide diffusion capacity, total lung capacity, and vital capacity. These associations will be evaluated further in a follow-up study.

Antineoplastic Combined Chemotherapy Protocols↗