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Biomedical subjects

O Gomez-Marin

Publications and source records attributed to O Gomez-Marin.

At least 37 records · Page 2Linked to original sources

Comparison of serum calcium levels between junior high school children with high-normal and low-normal blood pressure. The child and adolescent blood pressure program.

The objective of this study was to compare serum calcium levels, dietary calcium intake, and urinary calcium excretion between junior high students with high-normal and low-normal blood pressure. The study was conducted in 11- to 14-year-old children recruited after blood pressure screening of 5th to 8th grade Minneapolis and St. Paul Public School students. Comparisons were made between a group of 243 children selected from the upper 15 percentiles of the blood pressure distribution (high-normal group) and 40 children randomly selected from the lowest 10% of the blood pressure distribution (low-normal group). Blood samples were obtained from the participants at clinic visits conducted after school. Calcium measurements were based on the principle that serum calcium is found in three forms: 1) an ionized fraction; 2) a fraction complexed with organic anions such as citrate, phosphate, and lactate; and 3) a protein-bound fraction. Dietary calcium intake was determined from food diaries, and urinary electrolytes were determined in 24-h urine collections. Serum total calcium levels were not significantly different between groups. However, serum ultrafilterable, true ionized, ionized normalized for pH, and complexed calcium levels were significantly greater in the low-normal group. There was no significant difference in 24-h intake of calcium or other nutrients between the groups. The low-normal group excreted significantly more calcium than the high-normal group, but there were no significant differences in sodium, potassium, or chloride excretion. This report of the relation between calcium and blood pressure represents the first study in children or adolescents to include serum, dietary, and urine data.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Effect of low sodium diet or potassium supplementation on adolescent blood pressure.

The roots of essential hypertension extend back into the first two decades of life, suggesting that effective intervention during those years may lead to a reduction in the incidence of adult hypertension. Decreasing the dietary sodium/potassium ratio offers a potentially effective approach to blood pressure reduction. This study tested the feasibility of 3-year sodium reduction or potassium supplementation in adolescents and the effect of these interventions on the rate of rise of blood pressure during adolescence. After 19,452 5th to 8th grade students were screened, 210 from the upper 15 percentiles of blood pressure distribution (105 boys, 105 girls) were randomly assigned to one of three groups: low sodium diet (70 mmol sodium intake per day), potassium chloride supplementation (normal diet plus 1 mmol/kg potassium chloride per day), or placebo (normal diet plus placebo capsule). Capsules for the potassium chloride and placebo groups were administered in a double blind protocol. Blood pressure was measured every 3 months for 3 years. The effect of the intervention was determined by comparing the rate of rise (slope) of blood pressure among the groups using a random-coefficient growth curve model. The boys groups and the girls placebo group had similar positive blood pressure slopes that were significantly different from zero. The girls low sodium group had a slightly negative slope (significantly lower than the slope of the girls placebo group), and the girls potassium group had a slightly positive slope. Both of these slopes were not significantly different from zero and were significantly lower than the slopes of the respective boys groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

Change in survival from out-of-hospital cardiac arrest and its effect on coronary heart disease mortality, Minneapolis-St. Paul. The Minnesota Heart Survey.

Emergency medical services with advanced life support systems were implemented in the Minneapolis-St. Paul, Minnesota, area in the mid-1970s. To assess the impact of emergency medical services on coronary heart disease mortality, the authors reviewed ambulance records and hospital emergency room logs for possible out-of-hospital cardiac arrest cases in the period 1972-1982. Potential cases, and their survival to discharge, were validated by hospital record review and were checked against Minnesota death certificates for the year of cardiac arrest and the year following cardiac arrest. Age-adjusted rates of survival to 1 year after cardiac arrest (per 100,000 population) for survivors of out-of-hospital cardiac arrest aged 30-74 years increased significantly from 1972 to 1982 for men (1.8 vs. 11.7; p less than 0.00001) and for women (0.5 vs. 3.5; p less than 0.01). Coronary heart disease mortality rates declined in that period by 34.9% for men (from 527.5 per 100,000 to 343.3 per 100,000) and by 41.7% for women (from 168.6 per 100,000 to 98.3 per 100,000). The authors estimate that improved survival from out-of-hospital cardiac arrest contributed 5.4% (9.9 of 184.2) of the mortality decline for men and 4.3% (3.0 of 70.3) of the decline for women. This was a significant contribution to the decline in coronary heart disease mortality, but it explains only a small part of it.

Adult↗

Elevated blood pressure among Southeast Asian refugee children in Minnesota.

The blood pressures and body sizes of children aged 10-15 years in the Minneapolis and St. Paul, Minnesota, public schools were measured during 1986 and 1987. The sample consisted of 1,680 Southeast Asian refugees--including 219 Cambodians, 1,086 Hmong, 149 Lao, and 226 Vietnamese--and 3,424 blacks and 11,336 whites. Mean systolic blood pressure in Hmong boys was higher than that in black boys and white boys. Mean systolic blood pressures of Hmong, Lao, and Vietnamese girls were lower than those of black girls and white girls. The mean diastolic blood pressures of Hmong boys and of Cambodian and Hmong girls were greater than those of blacks and whites of the same sexes. Southeast Asian children were shorter and weighed less than black children and white children. Body size may confound associations between ethnic groups and blood pressures and may obscure the problem of hypertension among the smaller Southeast Asian children. Southeast Asian boys had greater mean systolic blood pressures than did black and white boys across all weight strata; a similar contrast among girls did not reveal this difference. The risk of hypertension, defined by US National Heart, Lung, and Blood Institute guidelines, was assessed in multiple logistic regression analyses that controlled for differences in weight, height, age, and pulse rate. The odds ratios for hypertension, relative to blacks and whites of the same sexes, were 2.69 (95% confidence interval (CI) 1.85-3.65) in Hmong boys, 2.89 (95% CI 1.35-6.21) in Lao boys, 2.10 (95% CI 1.03-4.28) in Cambodian girls, and 1.49 (95% CI 1.00-2.20) in Hmong girls. Hypertension and subsequent cardiovascular disease may emerge as a significant problem among Southeast Asian refugees in the United States.

Adolescent↗

Renal preservation after warm ischemia using oxygen free radical scavengers to prevent reperfusion injury.

Oxygen free radicals damage kidneys and accumulate during the period of preservation prior to transplantation. We hypothesized that a perfusate containing either an oxygen free radical scavenger such as ceruloplasmin, or an iron-chelating agent such as deferoxamine, would improve kidney preservation. Thirty-eight mongrel dogs underwent autotransplantation of the left kidney after 30 min of warm ischemia and 48 hr of machine perfusion (MOX-100, Water Instruments, Rochester, MN) at 5 degrees C and pH of 7.4. The right kidney was removed at the time of autotransplantation. Four blind code-labeled preservation solutions were tested. SGF-I was used for the control group (Group 1, n = 13), and the remaining animals were transplanted with kidneys preserved with one of three solutions modified from the basic SGF-I solution: Group 2, SGF-I plus deferoxamine (656 mg/liter), n = 8; Group 3, SGF-I ceruloplasmin enriched (72 mg/dl), n = 8; and Group 4, SGF-I ceruloplasmin reduced (3.4 mg/dl), n = 9. Serum creatinine levels were measured daily for 2 weeks and survival curves for each of the four groups were estimated by the Kaplan-Meier method. Peak mean serum creatinine levels +/- standard errors in Groups 1 through 4 were 12.6 +/- 1.97, 7.8 +/- 0.90, 7.1 +/- 1.26, and 8.2 +/- 1.09, respectively. Repeated measures analysis of variance showed statistically significant differences between the groups with respect to their serum creatinine profiles (Wald's test x2 with 3 df = 22.39, P value less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The effect of dentin pre-treatment and heat-augmented cure on marginal gap formation of a dentin bonding agent.

This study evaluated the effect of enhancing the cure of a DBA and the effect of dentin surface pre-treatment on marginal gap formation. Dentin cavities were prepared on extracted teeth and were pre-treated either with EDTA or phosphoric acid. Marginal leakage was expressed as percent length of margins with gaps. The mean percent length of margins with gaps for the chemically cured groups ranged from a maximum of 97% to a minimum of 85%. For the chemical/thermal-cured group, the mean percent length of margins with gaps was 95%, 95%, 73%, 35%, and 65%, corresponding to the following: pretreatment, no pre-treatment, EDTA, and phosphoric acid for 60, 15, or five s, respectively. SEM micrographs showed partial removal of one smear layer with EDTA and total removal of the smear layers with phosphoric acid. It is concluded that dentin pre-treatment methods have an effect on the percent length of margins with gaps when the DBA used had its cure supplemented with heat.

Acid Etching, Dental↗

Resin-bonded fixed partial dentures: a recall study.

A clinical recall program was initiated at the University of Minnesota to evaluate the longevity and factors affecting longevity of resin-bonded fixed partial dentures (FPDs). Of the 49 resin-bonded FPDs evaluated in the clinic, 43 were acid-etched metal, resin-bonded FPDs, four were combinations of resin-bonded and conventional FPDs, and two were composite resin pontics. None of the combination FPDs and one of the two composite resin pontics were judged as failed at the examination. Of the 43 acid-etched metal resin-bonded FPDs, 15 were found to be debonded (failure rate = 34.9%). The average length of service for the 43 FPDs was 47.3 months. The average time of placement to debondment was 33 months for the 15 debonded FPDs. The failure rate for maxillary FPDs and FPDs with two retainers were significantly lower than the failure rate for mandibular FPDs and FPDs with more than two retainers (p greater than 0.05). The clinical significance of the present study was discussed.

Adolescent↗

Diastolic fourth and fifth phase blood pressure in 10-15-year-old children. The Children and Adolescent Blood Pressure Program.

Measurement of diastolic blood pressure is complicated by the presence of two diastolic Korotkoff phases (fourth phase and fifth phase) in many children and adults. In the present study, diastolic fourth phase and diastolic fifth phase were evaluated in 1986-1987 in 19,274 Minneapolis-St. Paul school children aged 10-15 years. Approximately 50 percent of the children had no difference between fourth phase and fifth phase (i.e., fourth phase - fifth phase = 0) and 15 percent had a difference of only 1-4 mmHg. However, the fourth phase - fifth phase difference was 5-10 mmHg in 20 percent, 11-20 mmHg in 11 percent and greater than 21 mmHg in 3 percent of the children. Statistical analyses showed that the fourth phase - fifth phase difference tended to be greater in boys than girls and in older than younger children, was positively related to height, systolic blood pressure and fourth phase blood pressure, and negatively related to body mass index and fifth phase blood pressure. Using fifth phase instead of fourth phase in 10-12-year-old children and fourth phase instead of fifth phase in 13-15-year-old children to define diastolic blood pressures significantly changed the prevalence for significant diastolic hypertension by 2-3 percent.

Adolescent↗

Ratio of cuff width/arm circumference as a determinant of arterial blood pressure measurements in adults.

Recommendations state that the optimum ratio of blood pressure cuff width/arm circumference (CW/AC) is about 0.4. In this study of middle-aged men (n = 940) and women (n = 1484), we analysed the effect of CW/AC on blood pressure measurement variability and its interaction with age, body mass index (BMI), pulse rate and room temperature. In univariate polynomial regression, the variability (R2) in blood pressure that was explained by CW/AC was greater for women (systolic 6.3% and diastolic 5.7%) than for men (2.0% and 0.5%). In multivariate analysis the maximum variability explained independently by CW/AC was 2.7% for male and 6.7% for female systolic blood pressure, and 1.1% and 6.0% for male and female diastolic blood pressure, respectively. For systolic blood pressure this represented 10.4% of the explained variability in men and 9.3% of that in women. CW/AC is an important independent contributor to inter-individual variation in blood pressure measurement. It should therefore be taken into consideration in epidemiological studies and when medical care is being planned.

Adult↗

Prevalence of "significant" hypertension in junior high school-aged children: the Children and Adolescent Blood Pressure Program.

Blood pressure (BP) data obtained during a BP screening program were analyzed to determine the prevalence of "significant" hypertension, defined by the Second National Heart, Lung, and Blood Institute Task Force on Blood Pressure Control in Children-1987 as the level of BP above which medical evaluation and intervention are recommended. In 14,686 black and white St. Paul and Minneapolis schoolchildren aged 10 to 15 years, BP was measured twice during an initial screening examination. Children with systolic BP in the upper 30 percentiles of distribution after the initial screening had their BP remeasured two additional times at a rescreening examination. The prevalence of significant hypertension was determined according to BP criteria established by the Task Force report. After the two screening BP measurements were averaged, significant systolic hypertension was found in 1.0%, significant diastolic hypertension in 3.5%, and significant systolic or diastolic hypertension, or both, in 4.2% of the students. After the rescreening examination, the percentage of students remaining with significant hypertension was reduced to 0.3% for systolic, 0.8% for diastolic, and 1.1% for systolic or diastolic hypertension, or both. These results show that significant hypertension is uncommon in pre-high-school students and confirm the need for repeated BP measurements to make an accurate diagnosis of hypertension. However, the results should not detract from current recommendations to monitor BP in children on a yearly basis to detect longitudinal BP tracking patterns that may be consistent with early essential hypertension.

Adolescent↗

Canines erupted through grafted alveolar cleft defects in patients with alveolar clefts: a pulp testing evaluation study.

An electric pulp tester (EPT) was used to evaluate the pulpal response of erupted canines in 75 patients: 16 patients with unilateral cleft palate who received autogenous bone grafts to correct their alveolar cleft defects before canine eruption; 35 patients without cleft palate whose canines erupted spontaneously, but who required orthodontic treatment for alignment; and 24 patients without clefts whose canines required surgical uncovering and orthodontic assistance for eruption. Thirty-one percent of the erupted canines in the patients with grafted unilateral clefts did not respond to EPT, whereas all canines in the contralateral noncleft side responded to EPT. There was no clinical or radiographic evidence of pulpal pathosis of the canines that had erupted through the grafted alveolar clefts. However, these teeth had a high incidence of nonresponsiveness to pulp stimulation, therefore necessitating close follow-up in case they show eventual signs of pulpal degeneration that may require endodontic intervention.

Adolescent↗

"Significant" diastolic hypertension in pre-high school black and white children. The children and adolescent blood pressure program.

The Second Task Force on Blood Pressure Control in Children defines "significant" hypertension as blood pressure persistently above the 95th percentile for age-sex specific distribution. In this report we present preliminary data on the prevalence of significant diastolic hypertension in pre-high school black and white children after repeated blood pressure measurements. Blood pressure was measured in 10,446 children two times at an initial screening in school and remeasured two times at a rescreening in 2,808 children from the upper 30 percentiles of the initial screening distribution. Significant hypertension was found in 653 children (6.3%) after the first screening measurement and in 475 children (4.5%) after averaging the first two screening measurements. At the rescreening, the prevalence of significant hypertension was further reduced in this cohort to 1% after one measurement and to 0.8% after averaging the two measurements. The prevalence of significant systolic hypertension had fallen to 0.47% after averaging the two rescreening measurements. These data suggest that the prevalence of significant hypertension is very low in pre-high school children.

Adolescent↗

Postural changes in blood pressure and pulse rate among black adolescents and white adolescents: the Minneapolis Children's Blood Pressure Study.

Because studies have suggested a possible relation between vascular responsiveness to postural changes and risk of subsequent myocardial infarction, the reactivity of blood pressure and pulse rate to change from supine to standing positions was examined in 158 black males, 144 black females, 342 white males, and 272 white females aged 14-16 years. The study was part of the Minneapolis Children's Blood Pressure Study and was conducted during October to December 1985. Two blood pressure readings and one pulse reading were taken after five minutes of supine rest, immediately upon standing, and five minutes after standing. After adjustment for body mass index, mean systolic blood pressure decreased, and fourth- and fifth-phase diastolic blood pressures and pulse rate increased from supine to standing positions in all race and sex groups. Black males had significantly larger changes in systolic pressure than did white males (-5.9 vs. -4.1 mmHg), and males had significantly larger changes in fourth- and fifth-phase diastolic pressures compared with females of the same race (fourth-phase diastolic pressure, 8.0 vs. 4.1 mmHg for blacks and 10.0 vs. 4.8 mmHg for whites). Fifth-phase diastolic pressure increased more than did fourth-phase diastolic pressure in all groups. No race or sex differences were seen for pulse changes. For all race-sex groups, decreases in systolic pressure were positively correlated with initial levels of supine systolic pressure, whereas increases in fourth- and fifth-phase diastolic pressures were negatively correlated with corresponding initial levels. Measurement of postural changes may provide a clinically simple and reproducible way of testing for abnormalities in blood pressure and may better discriminate those at high risk of hypertension and its cardiovascular complications than would the commonly used single-seated blood pressure measurement.

Adolescent↗

Persistent elevation of blood pressure among children with a family history of hypertension: the Minneapolis Children's Blood Pressure Study.

We examined the blood pressure of children with and without a family history of hypertension in a longitudinal study. Supine blood pressures were first measured in schoolchildren (mean age 8 years) in 1978 and then on nine more occasions until 1986. Blood pressures of parents were measured in the seated position and their medical histories were obtained in home interviews carried out between 1978 and 1979. Children with a family history of hypertension had a higher mean systolic blood pressure (SBP) at the first screening compared to children without such a family history. This difference persisted at each of the succeeding nine school visits. The parents in hypertensive families had a lower income, greater body weight, were less well-educated and were more likely to be black than parents in families without a history of hypertension. Mothers in hypertensive families were more likely to have a history of heart disease and elevated blood pressure during pregnancy than mothers in normotensive families. The correlations between blood pressure of mothers and their children tended to be higher than those between fathers and their children. Elevated blood pressure emerges well before adolescence among children with a family history of hypertension and the family environment appears to play an important role in its development.

Blood Pressure↗

Improvement in long-term survival among patients hospitalized with acute myocardial infarction, 1970 to 1980. The Minnesota Heart Survey.

The mortality rate associated with coronary heart disease in the United States has declined steadily since 1968, but the reasons for this favorable trend have not been completely elucidated. In particular, it is not clear to what extent the decline reflects decreasing incidence as opposed to improved survival. To assess whether improved survival after myocardial infarction has contributed to the decline, the Minnesota Heart Survey compared the four-year survival rate in patients discharged with a diagnosis of acute myocardial infarction from hospitals in the Twin Cities area in 1970 and 1980. After adjustment for clinical characteristics related to outcome, the survival rate among patients with a definite myocardial infarction was significantly higher in the 1980 than in the 1970 group. The four-year survival for men was 35 percent better in the 1980 than in the 1970 group (95 percent confidence interval, 21 to 50 percent), and for women it was 27 percent better (95 percent confidence interval, 1 to 46 percent). Improvement in survival during the period of hospitalization accounted for 70 percent of the overall gain in survival between 1970 and 1980 in men and for virtually all of the gain in women. We conclude that improved long-term survival among patients with acute myocardial infarction has made an important contribution to the decline in mortality from coronary disease.

Female↗

Trends in cardiovascular risk factors in an urban black population, 1973-74 to 1985: the Minnesota Heart Survey.

Cardiovascular disease mortality rates have fallen dramatically in blacks in the United States. To determine whether this may be due to a decline in cardiovascular risk factors, we compared risk factors in a 1985 urban black population, ages 35 to 69, with those obtained in blacks of the same area in 1973-74. Age-adjusted mean body mass and the prevalence of overweight increased significantly over the 12-year period in both men and women. Mean systolic blood pressures declined significantly in both sexes, diastolic blood pressure declined significantly in men, and the proportion of men and women hypertensives on medication and under control increased. The overall prevalence of cigarette smoking changed very little, but the proportion of heavy smokers decreased significantly in men. No significant changes occurred in resting heart rate. Concurrently with these risk factor trends, age-adjusted heart disease mortality rates in area blacks fell 27% between 1968-73 and 1979-84, and stroke mortality fell 58%. Changing risk factors may be contributing to declining cardiovascular mortality rates in blacks. However, overweight seems to be a worsening problem.

Adult↗

Out-of-hospital coronary death in an urban population--validation of death certificate diagnosis. The Minnesota Heart Survey.

To assess the validity of death certificate diagnoses of out-of-hospital coronary heart disease deaths, the authors studied a one-third random sample of out-of-hospital deaths occurring in 1979 in Minneapolis-St. Paul, Minnesota, residents. Death certificates with diagnoses possibly containing coronary heart disease deaths were enumerated, and cause of death was recorded from the certificate in two ways: as the first listed ("immediate") cause and as the "underlying cause" assigned by a trained nosologist. Validation was performed by standardized physician review of information obtained about the death, which included one or more of the following: an interview with a relative or friend, physician report, autopsy report, medical record, and/or nursing home record. Missing information was frequent, but cases with at least an informant interview and/or autopsy report (82%) were representative and could be used for validation. The sensitivity and specificity of the underlying cause of coronary heart disease (International Classification of Diseases, Ninth Revision, codes 410-414, 427) on the death certificate were 90.3% and 82.7%, respectively, compared with the physician-assigned diagnosis. For the immediate cause, sensitivity and specificity were 90.3% and 67.9%, respectively. These findings suggest that the validity of death certificates for out-of-hospital coronary heart disease death is high, as assessed by this method of retrospective physician review.

Coronary Disease↗