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Biomedical subjects

C L Johnson

Publications and source records attributed to C L Johnson.

At least 73 records · Page 4Linked to original sources
PubMed1995

Outcome from critical care in the "oldest old" trauma patients.

This study evaluated the "oldest old" Intensive Care Unit (ICU) trauma patients, defined as patients of age 75 and over, to determine the relationships between age, injury magnitude, physiologic severity of illness, and outcome in this group, compared with younger trauma patients. Of 1,039 consecutive Surgical ICU (SICU) patients with complete data, 45 were in the Oldest group, 54 were in the Elderly group (ages 65 to 74), and 940 were in the Younger group (age < 65). Age, sex, and type of trauma (penetrating versus blunt) did not predict outcome. The Injury Severity Score (ISS) was significantly higher in the Oldest group than in the other groups (p = 0.0005), but the Trauma Score was the same for all groups. The proportion of Oldest group patients with ISS > or = 20 was significantly higher than for Elderly and Younger group patients (p = 0.0002 and p < 0.00005, respectively). The Simplified Acute Physiology Score (SAPS) on the first SICU day was the best outcome predictor for all age groups, along with maximum SAPS during the SICU stay (p < 0.00005 for both). When patients were stratified by ISS, there was a statistically significant difference in day 1 SAPS among age groups for most ISS categories, with higher SAPS associated with advancing age. The oldest old fare worse with trauma because their injury is more severe (higher ISS) and because their physiologic response to a given level of injury is exaggerated (higher SAPS). However, once the oldest old are stratified by SAPS, their outcome parallels that of their younger trauma cohorts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Methods to assess iron status in various NHANES surveys.

This paper summarizes iron status measurements included in the three cross-sectional National Health and Nutrition Examination Surveys (NHANES) completed to date, as well as a special study of Hispanics, known as the Hispanic Health and Nutrition Examination Survey (HHANES). Approaches for defining iron status in the population based on these measurements are also described as well as issues in comparing iron status data between surveys, using NHANES II and III data as an example.

Age Factors↗
PubMed1995

Verbal memory impairment after right temporal lobe surgery: role of contralateral damage as revealed by 1H magnetic resonance spectroscopy and T2 relaxometry.

We assessed performance on selected tests of verbal memory in 48 patients who had undergone either anterior temporal lobectomy or selective amygdalo-hippocampectomy for the relief of pharmacologically intractable epilepsy. We related performance both to the side of surgical excision and to the presence or absence of abnormalities in the contralateral, unoperated, temporal lobe, as revealed by proton magnetic resonance spectroscopy (1H MRS) or T2 relaxometry. There were abnormalities on the unoperated side detected by 1H MRS in 50% of the 34 patients who successfully underwent spectroscopy, and by T2 relaxometry in 33% of the complete series of 48 patients. There was no systematic relationship between seizure outcome and the presence or absence of abnormalities on the unoperated side. Verbal memory deficits were present in patients with left-sided excision, regardless of whether there were abnormalities on the unoperated side. The patients with right-sided excision also had verbal memory deficits, but only in the group with magnetic resonance abnormalities on the contralateral (ie, left) side and only on delayed recall. The study extends previous findings on the role of the temporal lobes in memory and highlights the role of these new magnetic resonance techniques in relating cognitive processes to brain structures.

Adult↗
PubMed1995

Macronutrient intakes among adult Hispanics: a comparison of Mexican Americans, Cuban Americans, and mainland Puerto Ricans.

OBJECTIVES: The purpose of this study was to compare energy and macronutrient intakes between adult Mexican Americans, Cuban Americans, mainland Puerto Ricans, and non-Hispanics. METHODS: Age-specific mean intakes were estimated based on 24-hour recalls from the Hispanic Health and Nutrition Examination Survey (HHANES) (1982 to 1984) and the Second National Health and Nutrition Examination Survey (NHANES II) (1976 to 1980) and were compared with the use of t tests. RESULTS: Mexican Americans had higher total fat, saturated fat, and monounsaturated fat intakes than did Puerto Ricans and older Cuban Americans. Cuban Americans and Puerto Ricans had similar intakes, except for younger Cuban Americans, who had higher total and saturated fat and lower carbohydrate intakes. Cholesterol intakes among Mexican American men and 60- to 74-year-old women were higher than those among other Hispanic groups. Carbohydrate and protein intakes were higher among Hispanic groups compared with those among non-Hispanics while total fat intakes were generally lower. CONCLUSIONS: Since macronutrient intakes differ between Hispanic groups, dietary research, recommendations, and interventions should be targeted to each group individually. Older Puerto Rican and Cuban American adults met population guidelines for reducing chronic disease risk for more macronutrients than any other group.

Adult↗
PubMed1994

Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988-91.

Intervention strategies aimed at reducing the prevalence of nutrition-related diseases, including designing nutrition policies and nutrition education and assistance programs, require effective monitoring of what Americans are eating. Nutrient reference data from the third National Health and Nutrition Examination Survey provide essential information to achieve these goals. Mean and median iron intakes were adequate in males of all race-ethnic groups but were generally low in females and young children. Mean and median calcium intakes were also higher in males than in females and were lower than recommendations in adolescents and in women of all ages. Mean sodium intakes for all age, sex, and race-ethnic groups exceeded the minimum requirements of healthy persons and were higher in non-Hispanic black children and adolescents than in non-Hispanic white and Mexican American children and adolescents. Mean fiber intakes also did not meet recommendations in most subgroups and were higher in Mexican American adults followed by non-Hispanic white adults and non-Hispanic black adults. Further research is planned to compare the food sources of energy and nutrients consumed by different population groups in NHANES III to similar results from earlier nation surveys. NHANES III, Phase 2 (1991-94) recalls were collected using the same dietary method as those collected in Phase 1 (1988-91), and other analyses will compare findings from both phases of NHANES III.

Adolescent↗
PubMed1994

Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991.

OBJECTIVE: To examine trends in overweight prevalence and body mass index of the US adult population. DESIGN: Nationally representative cross-sectional surveys with an in-person interview and a medical examination, including measurement of height and weight. SETTING/PARTICIPANTS: Between 6000 and 13,000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 to 1962 (the first National Health Examination Survey [NHES I]), 1971 to 1974 (the first National Health and Nutrition Examination Survey [NHANES I]), 1976 to 1980 (NHANES II), and 1988 to 1991 (NHANES III phase 1). RESULTS: In the period 1988 to 1991, 33.4% of US adults 20 years of age or older were estimated to be overweight. Comparisons of the 1988 to 1991 overweight prevalence estimates with data from earlier surveys indicate dramatic increases in all race/sex groups. Overweight prevalence increased 8% between the 1976 to 1980 and 1988 to 1991 surveys. During this period, for adult men and women aged 20 through 74 years, mean body mass index increased from 25.3 to 26.3; mean body weight increased 3.6 kg. CONCLUSIONS: These nationally representative data document a substantial increase in overweight among US adults and support the findings of other investigations that show notable increases in overweight during the past decade. These observations suggest that the Healthy People 2000 objective of reducing the prevalence of overweight US adults to no more than 20% may not be met by the year 2000. Understanding the reasons underlying the increase in the prevalence of overweight in the United States and elucidating the potential consequences in terms of morbidity and mortality present a challenge to our understanding of the etiology, treatment, and prevention of overweight.

Adult↗
PubMed1994

Age and velopharyngeal function during speech production.

This investigation was designed to determine if velopharyngeal function during speech production, as reflected in measures of nasal air flow, differs with age in adults. Eighty subjects were studied, 40 women and 40 men, representing four age groups (20-30, 40-50, 60-70, and 80 + years). Results showed no age-related differences in nasal air flow. Sex-related differences in flow were found on productions of nasal consonants only. These findings do not support the suggestion of Hutchinson, Robinson, and Nerbonne (1978) that velopharyngeal function deteriorates with age.

Adult↗
PubMed1994

Field evaluation of the NOVA Celltrak 12 hematology analyzer.

An evaluation of the NOVA Celltrak 12 was performed over a 6-week period. Precision, linearity, carryover, and reproducibility of values compared favorably to manufacturers' claims. The correlation was performed using the Coulter S Plus VI as the reference instrument and yielded coefficients of correlation for measured parameters of greater than .98 with the exception of RDW at r = .84, MCV at r = 0.96, and MPV at r = .92. Three-part differential information and an expanded flagging system affords increased clinical information and trouble-shooting guides. The three-part differential information compared favorably with that of the Coulter S Plus VI with lymphocyte percentage r = .96, granulocyte percentage r = .94, and monocyte percentage r = .50. We conclude that this instrument performed well in a clinical setting.

Blood Cell Count↗
PubMed1994

Constraints and facilitators to friendships in late late life.

This report analyzes friendship patterns of individuals 85 and older, 77% of whom are women. Despite high levels of disability and the loss of age peers, the majority were in frequent contact with friends and still had a close friend. Over 31 months, however, the predictors of friendship involvement changed. At Time 1, mood was most important, but by Time 3, increased disability was most important. Qualitative data describe how the constraints and facilitators lead to changing criteria for friendships in late late life.

Aged↗
PubMed1994

1H magnetic resonance spectroscopy in the investigation of intractable epilepsy.

We have been using proton magnetic resonance spectroscopy (1H MRS) in the investigation of adults and children with intractable epilepsy. Spectra were obtained from 2 x 2 x 2 cm cubes in the medial region of the temporal lobe, and were analyzed on the basis of signals from N-acetylaspartate (NAA), creatine+phosphocreatine (Cr), and choline-containing compounds (Cho). In comparison with control subjects, the epilepsy patients as a group show significant reductions in the NAA signal and in the NAA/Cho+Cr ratio, with increases in the Cho and Cr signals. The reduction in NAA is interpreted in terms of neuronal loss or damage, while the increase in Cr and Cho signals may be a reflection of reactive astrocytosis.

Adult↗
PubMed1994

Introduction: social and cultural diversity of the oldest-old.

UNLABELLED: This introduction describes a volume devoted to a much neglected topic and population, the social and cultural diversity among individuals eighty-five years old and older. Four articles come from the San Francisco 85+ STUDY: 1) comparisons by Colleen Johnson between whites and African Americans in socioeconomic status, health, and other outcomes; 2) Barbara Barer's analysis of gender differences in the stressors faced in late-life; 3) Charlotte Perry and Colleen Johnson's examination of the families of oldest-old African Americans; 4) Lillian Troll's analysis of white families. The fifth article by Gloria Clayton on rural/urban differences comes from the Georgia Centenarian STUDY. Finally the volume concludes with a commentary by Leonard Pearlin that places these studies into the broader context of aging research.

Activities of Daily Living↗
PubMed1994

Differential expectations and realities: race, socioeconomic status and health of the oldest-old.

Comparisons by race indicate that African Americans are significantly more disadvantaged than whites in their socioeconomic status. Despite complaints about their situation, however, African Americans report that their situation is better than they had expected. Although they perceive their health as poorer than whites, they are no more disabled functionally, and they have significantly better morale. Within-group correlations find the predictable associations between socioeconomic status and physical, psychological, and social outcomes for both groups. Nevertheless, both qualitative and quantitative data indicate that economic well-being is related to the congruence between expectations and the realities of life in advanced old age, making objective and subjective factors of similar importance.

Activities of Daily Living↗
PubMed1994

Families and support networks among African American oldest-old.

This article examines the demographic profile of oldest-old African-Americans who reside in the San Francisco Bay Area. Family life and social support available from adult children, relatives, and friends are explored as they vary by gender. Bivariate analyses indicate that females receive more help from relatives and friends, and males receive more help from immediate family members. Parent and childless respondents were compared for instrumental supports. The childless received support from a variety of helpers, whereas, the parents received help from family or the formal sector. Overall, fewer family members were available to assist the oldest-old with community living, although many were able to redefine relationships and increase the numbers of helpers available to assist them. These findings indicate that the principle of substitution operates among some segments of the older African American population, primarily those who are childless. This pattern was more evident among females than among males.

Black or African American↗
PubMed1994

Measurement of apolipoproteins A-I and B during the National Health and Nutrition Examination Survey (NHANES) III.

We measured apolipoproteins (apo) A-I and B by rate immunonephelometry (rate INA) during Phase 1 of the National Health and Nutrition Examination Survey (NHANES) III. We also made the measurements by radial immunodiffusion (RID) in a 20% subset of the samples. Aliquots of this subset were also analyzed in the Northwest Lipid Research Laboratories by fixed-time INA calibrated to the World Health Organization (WHO)-International Federation of Clinical Chemistry (IFCC) First International Reference Materials for Apolipoproteins A-I and B. The CVs for the rate INA and RID measurements were: apoA-I, 4.5-7.7% and 2.5-7.6%, respectively; apoB, 2.3-5.3% and 2.3-6.4%, respectively. In NHANES III, rate INA values (x) can be transformed to WHO-IFCC Reference Material-based values (y) as follows: for apoA-I, y = 0.87x + 251.8 mg/L (r = 0.93, SEslope = 0.13, SEintercept = 17, n = 708); for apoB (mg/L), y = 1.068x + 112.8 mg/L (r = 0.98, SEslope = 0.08, SEintercept = 7, n = 646).

Apolipoprotein A-I↗
PubMed1994

Trauma in the elderly: an analysis of outcomes based on age.

This study evaluated the comparative outcomes of elderly trauma patients admitted to a tertiary Surgical Intensive Care Unit (SICU) over a 5-year period (4/1/87-3/31/92). A total of 289 trauma patients 65 or older (mean age 76.3 +/- 0.4 years) were compared with 1,877 trauma patients under age 65 (mean age 31.4 +/- 0.3). The Simplified Acute Physiology Score (SAPS) severity of illness on admission for elderly trauma patients was 12.2 +/- 0.3, significantly higher than the SAPS of the younger patient group, 7.9 +/- 0.1 (P < 0.0005). Elderly survivors had higher than the SAPS of admission than their younger cohorts, 11.0 +/- 0.3 versus 7.3 +/- 0.1 (P < 0.0005), but there was no significant difference in SAPS for non-survivors. The Injury Severity Score (ISS) of elderly patients, 14.2 +/- 1.0, was not significantly higher than the ISS of younger patients, 12.3 +/- 0.3 (P = 0.06). Thirty-three elderly trauma patients (11.4%) died in the SICU, compared with 90 (4.8%) deaths in younger patients (P < 0.00005). However, when patients were stratified by admission SAPS, SICU mortality was nearly equivalent between the older and younger patient groups. An additional 14 elderly patients (4.8%) died in the hospital after SICU discharge, compared with 9 additional deaths (0.5%) in the younger patient group (P < 0.00005).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Prevalence of high blood cholesterol among US adults. An update based on guidelines from the second report of the National Cholesterol Education Program Adult Treatment Panel.

OBJECTIVE: To estimate the current levels and trends in the proportion of US adults with high blood cholesterol based on guidelines from the second report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP II). DESIGN: Nationally representative cross-sectional surveys. SETTING/PARTICIPANTS: Data for 7775 participants 20 years of age and older from phase 1 of the third National Health and Nutrition Examination Survey (NHANES III) (data collected from 1988 through 1991) and for 9797 participants 20 through 74 years of age from NHANES II (data collected from 1976 through 1980) were used. RESULTS: From the data collection period in NHANES II (1976 through 1980) to the period in NHANES III (1988 through 1991), the proportion of adults with high blood cholesterol levels (> or = 240 mg/dL [6.21 mmol bd) fell from 26% to 20%, while the proportion with desirable levels (< 200 mg/dL [5.17 mmol/L]) rose from 44% to 49%. Currently, using the ATP II guidelines and NHANES III data, 40% of all adults 20 years of age and older would require fasting lipoprotein analysis; and 29% of all adults would be candidates for dietary therapy (as compared with 36%, using NHANES II data). Based on 1990 population data, it is estimated that approximately 52 million Americans 20 years of age and older would be candidates for dietary therapy. Assuming that dietary intervention would reduce low-density lipoprotein (LDL) cholesterol levels by 10%, as many as 7% of all adult Americans (approximately 12.7 million) might be candidates for cholesterol-lowering drugs. This estimate reflects approximately 4 million adults with established coronary heart disease, of whom half are aged 65 years and older, and up to 8.7 million adults without established coronary heart disease, of whom up to 3.1 million are aged 65 years and older. CONCLUSIONS: Substantial progress has been made in reducing the prevalence of high blood cholesterol; yet a large proportion of all adults, approximately 29%, require dietary intervention for high blood cholesterol.

Adult↗
PubMed1993

Declining serum total cholesterol levels among US adults. The National Health and Nutrition Examination Surveys.

OBJECTIVE: To examine the secular trend in serum total cholesterol levels of the US adult population. DESIGN: Nationally representative cross-sectional surveys with both an in person interview and a medical examination that included the measurement of blood lipid levels. SETTING/PARTICIPANTS: Between 6000 and 13,000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 through 1962, 1971 through 1974, 1976 through 1980, and 1988 through 1991. RESULTS: Mean serum total cholesterol levels in US adults aged 20 through 74 years have consistently declined over the time period 1960 through 1991. More than half of the decline occurred during the time period 1976 through 1991. This decline occurred across the entire distribution of serum cholesterol levels and in all age-sex groups. High-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels have not changed, suggesting that the decline in total cholesterol levels is due to a decline in low-density lipoprotein cholesterol levels. CONCLUSIONS: These results document a continuing and substantial decline in serum cholesterol levels among US adults. They suggest that public health programs, designed to reduce cholesterol levels, are proving successful. The observed downward trend in serum cholesterol levels has coincided with a continuing decline in coronary heart disease mortality. These observations suggest that the Healthy People 2000 goal of reducing the mean serum cholesterol level of US adults to no more than 200 mg/dL (5.17 mmol/L) is attainable.

Adult↗