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Biomedical subjects

P Van Natta

Publications and source records attributed to P Van Natta.

7 recordsLinked to original sources
PubMed1987

The effect of intravenous thrombolytic therapy on left ventricular function: a report on tissue-type plasminogen activator and streptokinase from the Thrombolysis in Myocardial Infarction (TIMI Phase I) trial.

In Phase I of the NHLBI trial of Thrombolysis in Myocardial Infarction (TIMI), 290 patients admitted within 7 hr after onset of acute infarction were randomly assigned to intravenous treatment with either streptokinase (SK) or recombinant tissue-type plasminogen activator (rt-PA). Left ventricular function was measured from contrast ventriculograms in 145 patients with both pretreatment and predischarge studies analyzable. Regional wall motion in the infarct site was measured by the centerline method and expressed in units of standard deviations (SDs) from the mean motion in 52 normal subjects. Patients treated with rt-PA (n = 77) achieved a significantly higher reperfusion rate after 90 min of treatment. Perfusion of the infarct-related artery improved from visual grade 0 or 1 (total occlusion or penetration without perfusion) to grade 2 or 3 (partial or full reperfusion) in 62% receiving rt-PA vs 31% receiving SK (n = 68) (p less than .001). However, the ejection fraction did not change significantly from before treatment to before discharge in either treatment group (+0.7 +/- 6.7% vs +1.0 +/- 8.3%, respectively). A small but significant increase in regional wall motion was observed in each of the two groups (+0.4 +/- 0.8 vs +0.3 +/- 0.8 SD/chord, respectively; each p less than .001 compared with baseline). This was countered by declines in the hyperkinesis of the noninfarct region (-0.3 +/- 1.0 SD/chord [p = .01] compared with baseline and -0.2 +/- 1.0 SD/chord [p = .23], respectively). Analysis of the combined groups revealed that the ejection fraction increased only in patients who achieved reperfusion by 90 min after onset of therapy or who had subtotal occlusions initially. There was greater recovery of left ventricular function in patients who achieved reperfusion earlier vs later than 4 hr after symptom onset and in patients with vs without some collateral circulation to the infarct-related artery.

Cardiac Catheterization↗
PubMed1985

Depressive symptoms, social networks and social support of elderly women.

A total of 1,144 white married women aged 65-75 years living in Washington County, Maryland were interviewed during February-August 1979 as part of a larger study. This cross-sectional analysis was undertaken to investigate the question of whether or not selected demographic, social network, and social support characteristics of these women were related to their level of depressive symptoms. Women at the low end of the socioeconomic scale were found more likely to have a high level of depressive symptoms than were women at the high end. Two structural characteristics, size and homogeneity of the social network, were also found to be related to symptoms of depression, although only homogeneity of the social network reached statistical significance. There was a larger percentage of women with a high level of depressive symptoms among those with small networks and among those with heterogeneous networks. Those women with good quality networks, which offer the opportunity for social support, were much less likely to have a high level of depressive symptoms than others. Cross-sectionally, social network factors were related to level of depressive symptoms; this relationship now needs to be demonstrated prospectively.

Aged↗
PubMedDate not supplied

The influence of alcohol abuse as a hidden contributor to mortality.

Although only about 2-3 percent of annual deaths are attributed to one of the four underlying causes linked to chronic alcohol use, research results suggest that the impact of alcohol is much greater. The recent issue of mortality multiple cause of death tapes from National Center for Health Statistics permit exploration of associations of chronic alcohol abuse with conditions coded as underlying cause of death and provide leads for case-finding. Data analysis is reported from certificates of resident deaths in the United States in 1978. There are 12 groups of underlying causes for which the percentage of pairings with chronic alcohol abuse ranges from 4-16 percent of the number of deaths from the underlying cause. Age, sex, and metropolitan status of residence are associated with a listing of chronic alcohol abuse among decedents of liver cancer, varicose veins, symptomatic heart disease, septicemia, and respiratory system disease. Planners concerned with secondary prevention can use these clues provided by logistic regression modelling as an aid in case-finding.

Adult↗
PubMedDate not supplied

Smoking and drinking behavior before and during pregnancy of married mothers of live-born infants and stillborn infants.

Data from the 1980 National Natality Survey (NNS) and the 1980 National Fetal Mortality Survey (NFMS) are used to describe the drinking and smoking behavior of married mothers before and during pregnancy according to maternal race and Hispanic origin, age, and education. Typically, smokers were white mothers under 25 years of age with a high school education or less, and drinkers were white mothers 25 years of age and older with more than a high school education. When pregnancy was confirmed, reductions in smoking and drinking occurred. However, mothers of stillborn infants were less likely to stop smoking than were the mothers of live-born infants. Although the prevalence of drinking was much higher than was the prevalence of smoking among the mothers included in these surveys, the reduction in drinking was much more pronounced than was the reduction in smoking. For nearly every sociodemographic subgroup, the prevalence of smoking was higher and the prevalence of drinking was lower among mothers of stillborn infants than among mothers of live-born infants. Some of these differences are due to the age-race-health status makeup of the two NNS-NFMS populations sampled, and carefully controlled multivariate analyses are required to specify the relationship of maternal smoking and drinking to birth outcome. This descriptive analysis is the first step in that process.

Adult↗