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Biomedical subjects

V Osganian

Publications and source records attributed to V Osganian.

5 recordsLinked to original sources

Physical activity in a multiethnic population of third graders in four states.

OBJECTIVES: This research assessed the amount of daily physical activity in a multiethnic sample of US third-grade students. METHODS: Physical activity interviews were conducted with 2410 third graders from 96 schools in four states. Blood pressure, cholesterol, body mass index, timed run for distance, physical-activity self-efficacy, and perceived support for physical activity were also assessed. RESULTS: Students reported a daily average of 89.9 minutes of moderate to vigorous physical activity, 34.7 minutes of vigorous activity, and 120.4 minutes of sedentary behavior; however, 36.6% obtained less than 60 minutes of moderate to vigorous physical activity daily, and 12.8% reported less than 30 minutes. Boys reported more physical and sedentary activity than girls; White children reported more activity than Black or Hispanic children; California children reported the most activity and Louisiana children the least. Geographic location, male gender, lower cholesterol, higher perceived efficacy in physical activity, and higher social support were associated with more physical activity. CONCLUSIONS: Average reported activity met the Year 2000 objectives; however, many students reported less than recommended amounts of activity. These findings support the need for health promotion programs that increase the number of physically active children.

Analysis of Variance↗

Cardiovascular risk factors among third grade children in four regions of the United States. The CATCH Study. Child and Adolescent Trial for Cardiovascular Health.

Data on cardiovascular risk factors (body mass index, triceps and subscapular skinfolds, blood pressure, serum total cholesterol, high density lipoprotein (HDL) cholesterol, and apolipoprotein B) were collected as part of the baseline examination (fall 1991) of the Child and Adolescent Trial for Cardiovascular Health, a multicenter school-based intervention study for promoting healthful behaviors. A total of 5,106 third grade children (mean age, 8.76 years) in four states (California, Louisiana, Minnesota, and Texas) were examined. After excluding 194 children of other or unknown origin, the study population consisted of 3,530 Anglo-American children, 674 African-American children, and 708 Latino children. African-American children were the tallest by 1-3 cm (p < 0.0001), while Latino children had the largest body mass index (p < 0.05). Blood pressure levels were similar for boys and girls and among the three races, but systolic levels were 2 mmHg higher in Texas than at the other sites. Serum total cholesterol levels were 5 mg/dl higher in girls than in boys (p < 0.05), while HDL cholesterol levels were 2 mg/dl higher in boys (p < 0.05). HDL cholesterol levels were highest in African-Americans (55.5 mg/dl) compared with Anglo-Americans (50.7 mg/dl) and Latinos (51.3 mg/dl) (p < 0.0001).

Analysis of Variance↗

Diagnostic testing in acute myocardial infarction: does patient age influence utilization patterns? The Worcester Heart Attack Study.

To assess the impact of patient age on the use of diagnostic testing in the management of acute myocardial infarction, the authors reviewed the hospital charts of 4,109 patients hospitalized for validated acute myocardial infarction in the Worcester, Massachusetts, metropolitan area during selected years between 1975 and 1986. Older patients were more likely to be female and to have a prior history of angina, hypertension, and diabetes mellitus (p less than 0.001). Acute myocardial infarctions among older patients were more likely to be recurrent, anterior in location, non-Q wave, smaller as reflected by peak creatine kinase levels, and complicated by congestive heart failure, cardiogenic shock, and atrial fibrillation (p less than 0.001). In-hospital mortality was directly related to increasing patient age (p less than 0.001). Patterns of utilization of the following diagnostic tests were examined: Holter monitoring, radionuclide ventriculography, echocardiography, exercise testing, pulmonary artery catheterization, and coronary arteriography. After adjustment for differences in demographic and clinical characteristics and in-hospital mortality, patients aged 65 years and older were significantly less likely to undergo exercise testing than were patients less than age 55. Patients older than age 75 were significantly less likely to undergo radionuclide ventriculography, pulmonary artery catheterization, and coronary arteriography than were younger patients. Sex-specific analyses did not produce results substantially different from those for the overall study population. The results of this community-wide study suggest that among patients hospitalized for acute myocardial infarction, chronologic age may be an independent determinant of utilization patterns of diagnostic testing. These findings suggest the need for a prospective evaluation of this issue, with an additional emphasis placed on the contributions of functional status and noncardiovascular illness to decision-making in the clinical management of acute myocardial infarction patients.

Age Factors↗

Cardiogenic shock after acute myocardial infarction. Incidence and mortality from a community-wide perspective, 1975 to 1988.

BACKGROUND: Cardiogenic shock resulting from acute myocardial infarction is a serious complication with a high mortality rate, but little is known about whether its incidence or outcome has changed over time. As part of an ongoing population-based study of acute myocardial infarction, we examined trends over time in the incidence and mortality rate of cardiogenic shock after acute myocardial infarction. METHODS: We studied 4762 patients with acute myocardial infarction who were admitted to 16 hospitals in the Worcester, Massachusetts, metropolitan area between 1975 and 1988. We determined the incidence of and short-term and long-term mortality due to cardiogenic shock in each of six years during this study period. RESULTS: The incidence of cardiogenic shock complicating acute myocardial infarction remained relatively constant, averaging 7.5 percent. Multivariate regression analysis that controlled for variables affecting incidence revealed significant though inconsistent temporal trends in the incidence of cardiogenic shock. As compared with the risk in 1975, the adjusted relative risk (with 95 percent confidence interval) was 0.83 (0.54 to 1.28) in 1978, 0.96 (0.63 to 1.48) in 1981, 0.68 (0.42 to 1.12) in 1984, 1.16 (0.70 to 1.92) in 1986, and 1.65 (0.99 to 2.77) in 1988. The overall in-hospital mortality rate among patients with cardiogenic shock was significantly higher than that among patients without this complication (77.7 percent vs. 13.5 percent, P less than 0.001). The in-hospital mortality among the patients with shock did not improve between 1975 (73.7 percent) and 1988 (81.7 percent). Long-term survival during the 14-year follow-up period was significantly worse among patients who survived cardiogenic shock during hospitalization than among patients who did not have shock (P less than 0.001). CONCLUSIONS: The results of this observational, community-wide study suggest that neither the incidence nor the prognosis of cardiogenic shock resulting from acute myocardial infarction has improved over time. Both in-hospital and long-term survival remain poor for patients with this complication.

Aged↗

Impact of atrial fibrillation on the in-hospital and long-term survival of patients with acute myocardial infarction: a community-wide perspective.

As part of an ongoing community-wide study examining changes over time in the incidence and survival rates of 4108 patients hospitalized with validated acute myocardial infarction (MI) in 16 hospitals in the Worcester, Massachusetts, metropolitan area during calendar years 1975, 1978, 1981, 1984, and 1986, we examined changes over time in the proportion of patients with acute MI developing atrial fibrillation (AF) and the impact of AF on in-hospital and long-term survival for up to a 10-year follow-up period. The overall percentage of patients with AF complicating acute MI was 16.0%; this proportion increased over time from 13.3% in 1975 to 14.8% in 1978, 14.9% in 1981, 20.3% in 1984, and to 17.7% in 1986. Patients with AF experienced consistently higher in-hospital case fatality rates than MI patients without AF overall (27.6% versus 16.6%), as well as during each of the 5 years under study. The independent effect of AF on in-hospital survival was not upheld, however, when a variety of potentially confounding prognostic factors were controlled for in a multivariate analysis resulting in an adjusted odds ratio (OR) of 1.18 (95% confidence interval 0.90, 1.52). Among discharged hospital patients, while the crude long-term survival rate for patients with AF was poorer than that of patients without AF for the combined as well as for individual study periods, similar to the in-hospital findings the independent effect of AF on long-term prognosis was not upheld after use of a multivariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗