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Biomedical subjects

M C Nevitt

Publications and source records attributed to M C Nevitt.

115 records · Page 7Linked to original sources
PubMed1985

A comparison of the treatment of rheumatoid arthritis in health maintenance organizations and fee-for-service practices.

This study compares the use of health care services (hospital and ambulatory) by patients with rheumatoid arthritis who were under the care of rheumatologists in prepaid and fee-for-service arrangements. Participating physicians from a random sample of half the rheumatologists in northern California maintained a log of all their patients with well-established diagnoses of rheumatoid arthritis. We interviewed 822 of their patients, using a structured, validated phone survey to obtain information about health care use. Patients in prepaid plans had about the same number and type of hospitalizations and the same rate of surgery as those receiving fee-for-service care. However, fee-for-service patients made more ambulatory visits. We conclude that the use of expensive services (hospital admissions and surgery) for the care of patients with rheumatoid arthritis is not different in fee-for-service and prepaid settings.

Ambulatory Care↗
PubMed1984

Work disability before and after total hip arthroplasty. Assessment of effectiveness in reducing disability.

We evaluated the impact of total hip arthroplasty (THA) on work disability among working age persons. Just over one-third of those totally work disabled prior to THA were working at 1 or at 4 years after surgery. A significant long-term decrease in work disability after surgery was demonstrated by estimating disability prevented by THA, but the decrease was less than suggested by the literature. Preoperative work status and the number of painful joints were significant predictors of return to work.

Cost-Benefit Analysis↗
PubMedDate not supplied

Sex- and race-related differences in cross-sectional geometry and bone density of the femoral mid-shaft in older adults.

BACKGROUND: Femoral shaft fracture incidence increases in older adults and is associated with low-energy trauma. Apart from bone density, the distribution and size of bone contributes to its strength. AIM: To examine if bone geometry and density of the femoral mid-shaft in older adults differs by sex and race, we studied 197 White women, 225 Black women, 242 White men, and 148 Black men aged 70-79 years participating in the Health, Aging, and Body Composition study; a prospective cohort study in the USA. A secondary purpose of the study was to examine the association of site-specific muscle and fat to bone geometry and density. SUBJECTS AND METHODS: Subjects were community-dwelling and reported no difficulty walking one-quarter of a mile or climbing stairs. Mid-femoral volumetric bone mineral density (vBMD, mg cm(-3)), total area (TA), cortical area (CA), medullary area (MA), cross-sectional moments of inertia (CSMI: I(x), I(y), J), and muscle and fat areas (cm(2)) were determined by computed tomography (CT; GE CT-9800, 10 mm slice thickness). RESULTS: vBMD was greater in men than women with no difference by race (p < 0.001). Bone areas and area moments of inertia were also greater in men than women (p < 0.001), with Black women having higher values than White women for TA and CA. Standardizing geometric parameters for body size differences by dividing by powers of femur length did not negate the sex difference for TA and MA. Significant differences (p < 0.05) among the four groups also remained for I(x) and J. Mid-thigh muscle area was an independent contributor to TA in all groups (Std beta = 0.181-0.351, p < 0.05) as well as CA in women (Std beta = 0.246-0.254, p < 0.01) and CSMI in White women (Std beta = 0.175-0.185, p < 0.05). Further, muscle area was a significant contributor to vBMD in Black women. CONCLUSION: These results indicate that bone geometry and density of the femoral diaphysis differs primarily by sex, rather than race, in older well-functioning adults. In addition, site-specific muscle area appears to have a potential contributory role to bone geometry parameters, especially in women.

Aged↗