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Biomedical subjects

S Y Kimm

Publications and source records attributed to S Y Kimm.

31 records · Page 2Linked to original sources
PubMed1992

Primary care physicians and children's blood cholesterol.

BACKGROUND. In a national survey sponsored by the National Heart, Lung, and Blood Institute, 62% of primary care physicians of children (under age 18 years) believed that high levels of low-density lipoprotein cholesterol in childhood had a great effect on subsequent heart disease risk. RESULTS. About 75% believed high blood pressure, smoking, and diabetes had similar effects. Although routine cholesterol screening in children under age 10 was infrequent, 72% of physicians screened high risk children. The age at which screening was done varied markedly; more pediatricians screened children younger than 5 years. The majority of physicians who saw children with high blood cholesterol instituted nondrug therapy, with pediatricians being most apt to do so. Low saturated fat diets were prescribed by 26% of these physicians and 9% of physicians prescribed increased polyunsaturated diets. Twelve percent of physicians treating hypercholesterolemic children used lipid-lowering drugs. Among those using drugs, 9% based drug use on total blood cholesterol measurements only. Factors that affected physician treatment of childhood hypercholesterolemia included physician specialty type, organization of practice (group or solo), and the age distribution of the pediatric patient population.

Age Factors↗
PubMed1991

Self-concept measures and childhood obesity: a descriptive analysis.

Little is known about the possible effects of age, race, gender, or degree of obesity on measurements of self-concept in children. Our study of 130 obese children enrolled in an outpatient obesity clinic showed that their mean overall score on the Piers-Harris (P-H) Children's Self-Concept Scale was within the norms. However, certain subgroups scored low, with nonwhite children displaying the lowest self-esteem, particularly younger girls and adolescent males. For boys, the severity of obesity was inversely associated with the overall score and the intellectual school status subscale. Girls scored lower on anxiety. Younger white males scored the lowest on popularity. Our findings thus suggest that there is heterogeneity in self-concept measures among obese children, and that the use of subscales might provide greater insight and also possibly enhance sensitivity of the P-H in the investigation of obesity and self-concept.

Adaptation, Psychological↗
PubMed1990

Management of cardiovascular disease risk factors in children. A national survey of primary care physicians.

A national survey of family physicians, general practitioners, and pediatricians revealed substantial physician differences in managing cardiovascular disease risk factors in children aged 2 to 18 years. Pediatricians tended to screen younger children but were more conservative in treatment. General practitioners tended to screen less and to initiate intervention in older children, but were more aggressive in therapy. While only 9% of surveyed physicians measured blood cholesterol levels routinely, 72% screened children with family histories of cardiovascular disease. The majority routinely measured blood pressure, but the ages of first measurements differed among physicians. Surprisingly, of those who had treated children with elevated blood pressure or blood cholesterol, 54% said that they had ever used antihypertensive and 12% used lipid-lowering drugs in children, including angiotensin converting enzyme inhibitors and clofibrate. Half the surveyed physicians felt prepared to provide dietary counseling, but only 14% felt successful with it. When asked what they considered were the major cardiovascular risk factors, less than one third of the physicians cited all three major factors: hypertension, hypercholesterolemia, and smoking.

Adolescent↗
PubMed1990

Dietary patterns of U.S. children: implications for disease prevention.

Nutritional data from the second National Health and Nutrition Examination Survey (NHANES II) were analyzed to assess dietary patterns of a representative sample of U.S. children and youth ages 1-17 years. The data show that the average U.S. child's diet is relatively high in total and saturated fat and low in the ratio of polyunsaturated to saturated fat. These dietary patterns deviate from current dietary recommendations for the prevention of cardiovascular diseases. The percentage contributions of specific macronutrients to total energy intake (in kilocalories) were total fat, 35-36%; total carbohydrates, 49-51%; and protein, 15-16%. This is in contrast to current expert recommendations for children of 30% of kilocalories as total fat, 55% as carbohydrates, and 15% as protein. The observed intake of saturated fat in U.S. children was 13% of kilocalories vs a recommended level of 10% of kilocalories. The observed ratio of polyunsaturated to saturated fat intake was 0.4 vs a recommended ratio of 1.0. There were important racial differences in fat intakes, with blacks generally having higher cholesterol and total fat intakes. White children generally consumed more of their calories as carbohydrates than did black children, but there were no differences in protein intakes between the two groups. In summary, these data suggest that the average U.S. child's diet deviates from recommended dietary guidelines for fat and cholesterol intakes. Black children's dietary patterns appear less favorable for cardiovascular health than those of white children. However, the data also show that achieving recommended dietary intake patterns probably will not require drastic changes in the U.S. child's diet.

Adolescent↗
PubMed1983

Secular trends in ischemic heart disease mortality: regional variation.

We compared secular trends in ischemic heart disease (IHD) mortality in four southeastern states (North Carolina, Georgia, South Carolina, and Virginia) with those in three selected other states (California, New York, and Utah). Mortality data were obtained from U.S. vital statistics and population information from the U.S. Census Bureau. Age-adjusted IHD mortality increased until 1968 in the southeastern states and then declined and declines were greatest in the nonwhite female population. In contrast, IHD mortality in all groups in California and in the female population in New York and Utah began to decline in the early 1950s, with accelerated declines since 1968. In all states the decline in rates in nonwhite populations have been greatest in the younger age groups. This has not been true in the white populations. Declining IHD mortality correlated moderately well with the decline in death from all cardiovascular disease and from all causes, but not with the declining cerebrovascular disease mortality. Respiratory cancer mortality increased in similar proportions in California and South Carolina, two states with dissimilar IHD trends. These findings suggest that improved control of hypertension and changing patterns of cigarette smoking may not be responsible for the recent decline in IHD mortality.

Adult↗
PubMed1983

Effect of water rinsing on sodium content of selected foods.

The sodium content of water-rinsed canned green beans, tuna, and cottage cheese was analyzed. A 3-minute rinse of tuna and cottage cheese resulted in sodium reductions of 80% and 63%, respectively, with no significant effect on iron content. Calcium was reduced by approximately 50%. Although rinsing had a minimal effect on the sodium in canned beans, replacing the canning brine with water before heating lowered salt content by 33%. This study shows that the simple and economical methods of water rinsing of tuna and cottage cheese and of heating green beans in tap water markedly lowered salt content.

Food Analysis↗
PubMed1982

Assessment of the use of the age- and sex-specific United States population as a control group for analysis of survival in coronary artery disease.

The use of the age- and sex-specific U.S. population as a control group for analysis of survival in coronary artery disease was assessed. Population-based survival rates were calculated for nonsurgically treated patients evaluated for coronary artery disease at Duke University Medical Center. Survival of the overall group of medically treated patients with significant coronary artery disease was lower than the corresponding age- and sex-specific U.S. population rates. However, survival of patients with significant disease who had normal left ventricular contraction and stable chest pain was similar to the age- and sex-specific population survival rates. Both the observed survival and the population-based survival estimates for patients with normal left ventricular contraction and stable pain were lower than the survival of patients with normal coronary arteriograms. Even after deaths from ischemic heart disease are eliminated from the population rates, survival of patients with normal coronary arteries exceeded the age-and sex-specific population survival. Because of biases inherent in the selection of patients for cardiac catheterization and the presence of other serious diseases in persons in the general population is not an adequate control group for rigorous analysis of the effect of therapy in coronary artery disease.

Actuarial Analysis↗
PubMed1982

Environmental factors in the etiology of rhabdomyosarcoma in childhood.

In a case-control study of childhood rhabdomyosarcoma (RMS), families of 33 cases and 99 controls were interviewed. A relative risk (RR) of 3.9 was found associated with fathers' (but not mothers') cigarette smoking (P = 0.003). Cases had had fewer immunizations than controls, particularly smallpox vaccination (RR = 0.2; P = 0.001), and conversely had more preventable infections. An RR of 3.2 (P = 0.03) was found associated with exposure to chemicals and and RR of 3.7 (P = 0.004) was found associated with diets that included organ meats. Mothers of cases were more likely to be over age 30 years at subject's birth, to have used antibiotics preceding or during pregnancy, and to have had an overdue and/or assisted delivery. Other findings suggest that low socioeconomic status is associated with an increased risk of RMS. These aggregate findings imply that environmental factors may play an important role in the etiology of childhood RMS.

Adolescent↗