Biomedical subjects
K A Muñoz
Publications and source records attributed to K A Muñoz.
Patterns of care for women with ovarian cancer in the United States.
PURPOSE: To characterize treatments for ovarian cancer, to determine if recommended staging and treatment were provided, and to determine factors that influence receipt of recommended staging and treatment. METHODS: A total of 785 women diagnosed with ovarian cancer in 1991 were selected from the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) program. Type and receipt of recommended staging and treatment were examined using data on surgery and physician-verified chemotherapy. RESULTS: Most women with presumptive stage I and II ovarian cancer were treated with surgery alone (58%), while women with stage III or IV disease were treated with surgery plus platinum-based chemotherapy (75% stage III, 56% stage IV). Approximately 10% of women with presumptive stage I and II, 71% with stage III, and 53% with stage IV disease received recommended staging and treatment. The absence of lymphadenectomy and assignment of histologic grade were the primary reasons women with presumptive stage I and II cancer did not receive recommended staging and treatment, whereas for stages III and IV, it was due to older women not receiving surgery plus platinum-based adjuvant chemotherapy. Age, stage, comorbidity, "other" race/ethnicity, and treatment at a facility with an approved residency training program were associated with whether recommended staging and therapy were received. CONCLUSION: Older women with late-stage disease did not receive recommended treatment. The majority of women with early-stage disease did not receive recommended staging and treatment.
Food intakes of US children and adolescents compared with recommendations.
OBJECTIVES: To determine the proportion of youth meeting national recommendations for food group intake and to identify food intake patterns. DESIGN: The US Department of Agriculture's 1989-1991 Continuing Surveys of Food Intakes by Individuals were used to estimate food intake. Intake was determined from 3 days of diet by disaggregating foods into their component ingredients and using weights that correspond to servings. PARTICIPANTS: The sample included 3307 youth, 2 to 19 years of age, living in the 48 conterminous United States. Main Outcome Measures. Mean number of servings and percentage of individuals meeting national recommendations for food group intake according to demographic characteristics, patterns of intake, and nutrient profiles associated with each pattern. RESULTS: Mean numbers of servings per day were below minimum recommendations for all food groups except the dairy group (ages 2 to 11). Percentages of youth meeting recommendations ranged from approximately 30% for fruit, grain, meat, and dairy to 36% for vegetables. Sixteen percent of youth did not meet any recommendations, and 1% met all recommendations. The pattern of meeting all recommendations resulted in nutrient intakes above the recommended dietary allowances and was high in fat. Conversely, meeting none of the recommendations resulted in intakes well below the recommended dietary allowances for some nutrients. Total fat and added sugars averaged 35% and 15% of energy, respectively, and levels were similar among most demographic groups. CONCLUSION: Children and teens in the United States follow eating patterns that do not meet national recommendations. Nutrition education and intervention are needed among US children.
Recall of body weight and body size estimation in women enrolled in the breast cancer detection and demonstration project (BCDDP).
OBJECTIVE: To examine the relationship between body mass index (BMI) and pictorial representations of body size in women from young adulthood to late mid-life. DESIGN: Retrospective, descriptive study of BMI and pictorial estimation of body size. SUBJECTS: 5,807 women age 33-77 years enrolled in the National Cancer Institute's and American Cancer Society Breast Cancer Detection and Demonstration Project (BCDDP). MEASUREMENTS: Body weight and height were measured in 1973. In 1977, a subset of the cohort recalled their usual height and weight at 10 y intervals starting at age 20. In 1987, subjects reported their usual and current weight and selected one of nine pictorials best representing their body size at ages 15, 25, 40, 50 and +60 y. RESULTS: For the cohort, and among White women, Pearson correlations between recalled BMI (Kg/M2) and pictorials for each decade ranged from 0.62-0.67 and was 0.80 for current BMI and current pictorial. The range of correlations between pictorials and recalled BMI for other race/ethnic groups were 0.72-0.87 (Black), 0.53-0.75 (Hispanic) and 0.28-0.87 (Asian). Among a subset of women with data on measured BMI, recalled BMI and pictorials at specific ages, the correlation between pictorials and measured BMI was 0.75, compared to the correlation between recalled BMI and measured BMI which was 0.89. CONCLUSION: Correlations are higher between recalled BMI and measured BMI compared to the correlation between pictorials and measured BMI. Therefore, estimates of body size by pictorials alone may not be appropriate for epidemiological investigations. Alternate uses of pictorials may include assessment body weight in low literate populations or in instances where body weight is not or has not been measured.