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Biomedical subjects

R Lantigua

Publications and source records attributed to R Lantigua.

9 recordsLinked to original sources
PubMed1995

Differences in the prevalence of essential tremor among elderly African Americans, whites, and Hispanics in northern Manhattan, NY.

BACKGROUND: Until now there has been only one community-based study to examine interethnic differences in the prevalence of essential tremor (ET). The study suggested a higher prevalence among whites than African Americans. The present study is the first to examine differences in the prevalence of ET among Hispanics, African Americans, and whites. OBJECTIVE: To estimate the prevalence of essential tremor (ET) in a cohort of community-dwelling elderly of mixed ethnic background. METHODS: A random sample of 2117 Medicare recipients residing in Washington Heights-Inwood in northern Manhattan, NY, were interviewed. A standardized neurological assessment was performed on those who had neurological complaints and on a random sample of those who did not. Essential tremor was defined as a postural or kinetic tremor of the head or limbs. Diagnoses were independently confirmed by two neurologists based on videotaped examination. RESULTS: After age adjustment to the 1990 Washington Heights-Inwood census, the prevalence of ET was 40.2 per 1000 (95% confidence interval, 31.8 to 48.6). Among 46 cases with ET, ET was significantly more prevalent in men than in women (chi 2 = 5.0, P = .03). Prevalence increased significantly with age. The prevalence was higher in whites than African Americans. The prevalence in Hispanics was intermediate. CONCLUSION: The prevalence of ET increases with age and may be higher among men and whites. Prospective studies are needed to further examine these associations.

Black or African American↗
PubMed1995

The availability of low-fat milk in an inner-city Latino community: implications for nutrition education.

Substitution of low-fat for whole milk is an important strategy for reducing saturated fat consumption, but intake of whole milk remains high among Latinos. To assess whether this is related to the unavailability of low-fat milk, we surveyed 251 grocery stores (bodegas) and 25 supermarkets in a predominantly low-income, urban Latino community. Low-fat milk was available in 73% of bodegas and 96% of supermarkets, but it constituted only 15% of total milk volume in bodegas and 37% of that volume in supermarkets. Since lack of availability was not a major obstacle to increasing low-fat milk consumption, public health nutrition campaigns should focus on increasing consumer demand.

Animals↗
PubMed1992

Diagnosis of dementia in a heterogeneous population. Development of a neuropsychological paradigm-based diagnosis of dementia and quantified correction for the effects of education.

A brief diagnostic battery of neuropsychological tests was developed for a large-scale epidemiological study of dementia. We operationally defined dementia as defective memory and defective performance in at least two other areas, including orientation, abstract reasoning, construction, and language. Criterion scores for defining defective performance on each test were developed. In a pilot study that used 51 different subjects with a working diagnosis based on physicians' assessment (ie, 32 demented and 29 nondemented subjects), the test-based diagnosis agreed with the working diagnosis in all but two cases. The test battery was then applied to 430 healthy elderly subjects. Eighteen percent of those with 8 or less years of education met criteria for dementia compared with 5% of those with more than 8 years of education. We computed education-corrected scores for each test with the use of residuals from the regression of each test score on education. Based on corrected scores, 12 subjects were reclassified as nondemented and 11 as demented. Subjects who were reclassified as demented were significantly more impaired in activities of daily living than nondemented subjects who were not reclassified. Activities of daily living in subjects who were reclassified as nondemented did not differ from those in demented subjects who were not reclassified. These findings suggest that the neuropsychological battery may have utility in the diagnosis of dementia. However, neuropsychological performance may be influenced by education, and some form of adjustment, such as correction for activities of daily living, may be required in epidemiological studies.

Activities of Daily Living↗
PubMed1992

The Washington Heights-Inwood Healthy Heart Program: a third generation community-based cardiovascular disease prevention program in a disadvantaged urban setting.

The Washington Heights-Inwood Healthy Heart Program (WHIHHP) is part of the New York State Healthy Heart Program, which comprises eight community-based programs in different areas of the state. WHIHHP is directed at a population of approximately 200,000 people, predominantly Hispanic and of low socioeconomic status, living in northern Manhattan in New York City. The initial 3 years of experience are presented. Six potential barriers to diffusion of the community-based disease prevention model in disadvantaged inner city communities are discussed: (a) issues of scale and complexity; (b) adaptation of this model to a "community" without geopolitical boundaries or infrastructure; (c) linguistic and cultural diversity; (d) competing problems; (e) the role of evaluation; and (f) sustainability of the program in a poor community. Strategies for addressing obstacles to model adoption are also described, including program legitimization, building program infrastructure, setting realistic expectations, focusing on one risk factor at a time, defining target population segments, and emphasizing a small number of communication channels. Finally, research issues related to the diffusion of the community-based model are discussed, specifically: (a) Does the model work in disadvantaged urban settings? (b) What are the program effects on social class gradients for risk factors? (c) What are the barriers to program adoption in such settings? (d) What changes in the model will facilitate adoption in such settings? (e) What are the best methods for conducting formative evaluation in such programs? (f) What is the best way to select communities that may be ready to adopt the model? Our initial experience implementing this model in a disadvantaged urban setting supports the feasibility of model adoption. Unanswered questions about efficacy in such settings and regarding research issues related to model diffusion will require additional research investment.

Adolescent↗
PubMed1991

Independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease.

The authors examined the independent associations of educational attainment and ethnicity with behavioral risk factors for cardiovascular disease using data from the 1989 baseline survey for the New York State Healthy Heart Program. This telephone survey used the Centers for Disease Control Behavioral Risk Factor Survey interview instrument and was conducted in eight communities (total population, approximately 1.24 million people) in New York State. The response rate was 65.5% (n = 4,179); 3,606 subjects aged 20-64 years with self-described ethnicity of white (n = 1,935), black (n = 1,035), or Hispanic (n = 636) and of known educational status were retained in the analysis. After adjustment for age, sex, and ethnicity, significant associations were found between educational attainment and smoking, lack of regular exercise, overweight, diet atherogenicity, and knowledge about blood pressure and cholesterol. After adjustment for age, sex, and educational attainment, associations were found between ethnicity and most of these same variables. Blacks and Hispanics generally had less favorable risk factor profiles. These data indicate that the differences in cardiovascular disease risk profiles between whites and blacks or Hispanics cannot be fully explained by underlying differences in educational attainment. The differing patterns of risk factor distribution by educational attainment within ethnic groups have implications for the segmentation of risk reduction programs.

Adult↗
PubMed1991

Reliability of the behavioral risk factor survey in a triethnic population.

The Behavioral Risk Factor Survey (BRFS) is a telephone interview used widely by the Centers for Disease Control (CDC) in conjunction with state health departments to measure prevalences and time trends for health-related behaviors. We assessed the reliability of those parts of the BRFS related to cardiovascular disease (smoking, diet, obesity, exercise, and hypertension) and demographics by readministering the BRFS in July and August of 1989 to 145 randomly selected subjects between 10 and 21 days following completion of an initial interview. Sampling and data collection closely followed CDC procedures. The retest samples comprised 49 whites, 43 blacks, and 53 Hispanics living in northern Manhattan in New York City. Group prevalences or means were compared at first and second interviews for six demographic variables and 12 behavioral risk factor variables for the samples as a whole and separately for each ethnic group. All of these comparisons were highly consistent, and none showed a statistically significant difference. At the individual level, Pearson or kappa correlations for 19 questions related to demographics and behavioral risk factors other than diet were greater than or equal to 0.60 (p less than 0.001) for all except routine checkup in the past 2 years (kappa = 0.54; p less than 0.001) and blood pressure measured in the past 2 years (crude concordance, 96%; kappa = 0.23; p less than 0.01). For 17 food items, correlations for frequency of consumption ranged from 0.44 to 0.76 (p less than 0.01). For a composite index of diet "atherogenicity" based on the 17 food items, r = 0.62 (p less than 0.001). This test-retest reliability study of the BRFS showed high consistency at the group level and acceptable to high item reliability at the individual level for the parts of the BRFS related to demographics, cardiovascular behavioral risk factors, and a 17-item nutrition module. Findings were generally consistent in all three ethnic groups.

Adult↗
PubMed1981

Adverse effects of liquid protein fast on the handling of magnesium, calcium and phosphorus.

We have studied the effect of a vitamin- and potassium-supplemented liquid protein fast on mineral metabolism of six obese subjects (five women, 1 man) for 40 days. Each patient was admitted to a metabolic ward and was given daily 300 Kcal, 75 mg of calcium, 406 mg of phosphorus, 7 mg of magnesium, 33 meq of potassium, and 11.5 g of nitrogen. Urinary calcium, phosphorus and magnesium levels were greatest during the first week, but decreased as the fast continued to 21, 31 and 300 percent, respectively, above intake. Cumulative urinary losses of calcium, phosphorus and magnesium were 58, 75 and 500 percent greater, respectively, than the cumulative intake. Fecal losses for calcium, phosphorus and magnesium were less than urinary losses throughout the study. Cumulative fecal losses of magnesium were more than 30 percent greater than dietary intake. Mean daily balances were -104 mg (calcium), -48 mg (magnesium) and -363 mg (phosphorus). Serum phosphorus and magnesium levels did not change. However, serum calcium levels decreased (-0.5 mg/dl, p less than 0.05). Serum bicarbonate levels decreased 20 percent during the first 8 days of the fast, at which time urinary ammonium was maximal, but later returned to control values despite sustained increases in serum and urinary acids throughout the fast. Ammonium excretion was 260 to 300 percent above control values. Urinary titratable acid excretion was greatest early in the fast but subsequently decreased as the excretion of phosphorus declined. Titratable acid accounted for less of the excreted acid (7 to 21 percent) than did ammonia (70 to 90 percent). It is concluded that a liquid protein fast results in negative mineral balance that is not reflected by serum values and is due primarily to renal losses. The losses of magnesium were proportionally greater than those of calcium and phosphorus. These studies indicate that a liquid protein fast results in depletion of the intracellular and/or skeletal stores of these minerals.

Adult↗
PubMed1981

Errors in potassium balance.

Six overweight adult subjects given a low calorie diet containing adequate amounts of nitrogen but subnormal amounts of potassium (K) were observed on the Clinical Research Center for periods of 29 to 40 days. Metabolic balance of potassium was measured together with frequent assays of total body K by 40K counting. Metabolic K balance underestimated body K loses by 11 to 87% (average 43%); the intersubject variability is such as to preclude the use of a single correction value for unmeasured losses in K balance studies.

Adult↗