Biomedical subjects

M Van Natta

Publications and source records attributed to M Van Natta.

6 recordsLinked to original sources

PubMed1995

Epidemiology of hip fractures among the elderly. Risk factors for fracture type.

A study was undertaken in September 1988 of 169 patients who were > 50 years of age receiving care for hip fractures at 4 university-affiliated hospitals during a 2-year period. Demographics, medical history, cognitive function, mobility, and environmental factors surrounding the hip fractures were ascertained by patient or proxy interview and review of medical records. These were then related to the type and severity of hip fracture. Eighty-three (49%) patients had intertrochanteric fractures, 23 (14%) had subtrochanteric fractures, and 63 (37%) had intracapsular fractures. Walking versus standing, sitting, or getting up at the time of fracture (relative odds = 3.2, p = .041), and no mobility difficulty versus some mobility difficulty (relative odds = 5.2, p = .047) were associated with increased comminution in intertrochanteric or subtrochanteric fractures. The location of the fracture occurrence (indoor versus outdoors) was associated with greater displacement in intracapsular fractures (relative odds = 6.7, p = 0.021). Only 2 of 169 patients had spontaneous hip fractures, defined as hip pain that preceded the fall. Because spontaneous fractures are rare, efforts directed toward preventing falls would be expected to decrease the incidence of hip fractures. Future possibilities include the development of protective garments that can reduce impact loading to the hip during a fall.

Accidental Falls↗

PubMed1994

Can injurious falls be prevented?

The resident population in facilities changes over time. In some facilities there may be a large turnover of residents; in other types of facilities some residents will remain, age in place and become more frail. In addition, some medical conditions and intrinsic factors cannot be changed. Since there is not a single set of factors that can guide nursing staff as to which residents are at high risk for serious injurious falls, taking some general protective actions is appropriate. Some examples are: Monitoring the use of psychotropic medications through the MDS. Assessing the environment to determine potential risks that can be minimized or abolished. Using hip protectors to reduce hip fractures among elderly residents who fall.

Accidental Falls↗

PubMed1991

Age- and sex-specific incidence rates of migraine with and without visual aura.

Age- and sex-specific incidence rates for the onset of migraine headache with and without preceding visual aura were estimated from a population-based telephone interview survey conducted between March 1986 and June 1987 of 10,169 randomly selected residents of Washington County, Maryland, between the ages of 12 and 29 years. A total of 392 males and 1,018 females were identified as having a history of migraine. Of these, 27% of male cases and 28% of female cases were defined as having migraine with visual aura. Among both males and females, the incidence rate for migraine with visual aura appears to have peaked as much as 3-5 years earlier than the age peak for migraine without aura. For males, the age-specific incidence for migraine with visual aura appears to have peaked on or before 5 years of age at 6.6/1,000 person-years, or possibly higher. In contrast, the highest incidence for migraine without aura occurred between 10 and 11 years of age at 10.1/1,000 person-years. New cases of migraine were uncommon among males in their late 20s. The initial onset of migraine headache begins at a later age among females than among males. For females, the highest incidence of migraine with aura occurred between 12 and 13 years of age at 14.1/1,000 person-years; the highest incidence for migraine without aura occurred between 14 and 17 years of age at 18.9/1,000 person-years. In contrast to males, new onset of migraine was relatively common among females in their late 20s.

Adolescent↗

PubMed1990

Hypertension Prevention Trial (HPT): food pattern changes resulting from intervention on sodium, potassium, and energy intake. Hypertension Prevention Trial Research Group.

The Hypertension Prevention Trial (HPT) was a multicenter randomized trial designed to assess the effects of long-term dietary changes on blood pressure in a normotensive population (diastolic blood pressure greater than or equal to 78 but less than 90 mm Hg) for a period of 3 years. The dietary treatments were reduction of sodium intake, increase of potassium intake, and decrease of energy intake. Estimates of changes in food intake were made by comparing 24-hour food records of the treatment and control participants. The participants in the treatment groups reported sodium intakes that were 30% to 40% lower than those of the controls. The restriction was achieved mainly by reducing intake of salt, meats, and grain products. Meats and grain products were still a major source of total sodium intake after treatment (41% to 47%), perhaps because of continued use of processed foods. Potassium intake was reported to be 16% to 25% higher in the treatment groups than in the controls, the increase achieved largely through increased consumption of fruits, with a lesser contribution from vegetables. Participants with higher initial body weights reported smaller increases in fruit and vegetable consumption than participants of normal weight, perhaps because of concerns about weight gain. Energy intake in the weight loss groups was 8% to 11% less than that of the controls. Men reported success in restricting calories from meats, dairy products, fats, beverages, and sugars. Women were less successful in restricting calories from most food groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗

PubMed1989

Estimating age incidence from survey data with adjustments for recall errors.

In this paper we propose a method and discuss the type of data required to estimate age incidence rates from population survey data. While surveys are typically designed to estimate the prevalence of a disease or medical condition, they can also be used to estimate incidence rates. A limitation of survey data, however, is that recall is prone to errors. Three types of errors are common: telescopic, false negative, and false positive reports. Telescopic reports are thought to be the most common. We propose a method to adjust for recall errors by modeling the reported age of onset (ONST) and the time interval since the reported first occurrence of the medical condition (LAG). A number of models were examined using migraine headache data from over 10,000 subjects in Washington County, Maryland. Population surveys should be considered as a relatively inexpensive means for estimating the age incidence of medical conditions, especially for symptom based problems like back pain, asthma, mental illness, and serious headache. We recommend that data be collected on variables which can be used as surrogates for the different types of recall errors. Specifically, the age at interview, the date when the condition was cured or in remission, the severity of the condition, and possibly a specific inquiry as to how certain the respondent is in reporting the date of medical events, should be considered for this purpose.

Adolescent↗

PubMedDate not supplied

Prevention of hip fractures in the elderly: receptivity to protective garments.

A case study was undertaken to determine perceptions about protective garments for the prevention of recurrent hip fractures. We studied 169 patients with hip fractures, over 50 years of age, who were admitted to four university-affiliated hospitals. Proxy respondents were interviewed for 36% (n = 61) of the patients. Significant differences were found in the two groups; therefore, only the analyses from 108 patients who were interviewed are reported. Seventy percent of the patients were willing to wear a padded garment prescribed by a doctor. Factors associated with a positive response were no previous hip fracture, and an intrinsic cause of the fracture (P <or= 0.05). Over half (55%) of the patients were willing to wear an inflatable garment. Being female and fracturing the hip away from home were two factors that were associated with a positive response. Characteristics of the protective garment that patients thought were a concern or very important were effectiveness (83%), fit (82%), comfort (78%), laundering (66%), cost (57%), not showing (55%) and looked well (54%). These findings may assist investigators in the design of protective garments and thereby increase the receptivity and compliance among elderly patients.

Journal Article↗