Biomedical subjects

T Tyry

Publications and source records attributed to T Tyry.

3 recordsLinked to original sources

PubMed2006

Does multiple sclerosis-associated disability differ between races?

OBJECTIVE: To investigate differences in disability between African American and Caucasian patients with multiple sclerosis (MS) by comparing the relationship between current age and disability between races and by assessing the effect of adjustment for socioeconomic status (SES) on the associations. METHODS: The authors selected US participants from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry with an age at symptom onset of 10 to 60 years, who reported their race as Caucasian or African American (n = 21,557). They classified participants as having mild, moderate, or severe disability in the domains of mobility, hand function, cognition, and vision using Patient Determined Disease Steps and Performance Scales and assessed the association of disability with race using polytomous logistic regression. RESULTS: Disability increased more rapidly with increasing disease duration in older patients, but there was no interaction between race and age. African Americans had increased odds of severe vs mild disability in all four domains (odds ratio [OR] [95% CI]: hand 1.35 [1.10 to 1.64]; vision 1.75 [1.37 to 2.27]; cognition 1.32 [1.04 to 1.67]; mobility 1.32 [1.11 to 1.56]). Adjustment for all covariates, including SES, attenuated these associations (OR [95% CI]: hand 1.27 [1.00 to 1.61]; vision 1.59 [1.19 to 2.08]; cognition 0.98 [0.74 to 1.30]; mobility 1.37 [1.11 to 1.67]). Lack of adjustment for SES produced stronger associations. After enrollment in NARCOMS, disability progression did not differ between the groups. CONCLUSIONS: African Americans experience greater multiple sclerosis-associated disability than Caucasians. Failure to account for socioeconomic status leads to overestimation of these differences. Disease progression is similar in African Americans and Caucasians after diagnosis.

Adolescent↗

PubMed2005

Changes in the ascertainment of multiple sclerosis.

OBJECTIVE: With diagnostic criteria alterations, increased MRI availability, and awareness of therapies, temporal changes in incidence and prevalence rates may occur, with an increase in the proportion of mildly affected persons diagnosed with multiple sclerosis (MS). The authors assessed temporal trends in the delay from symptom onset to diagnosis (DONDX), and determined whether the degree of disability at diagnosis differs by year of symptom onset (YONSET), using the NARCOMS Registry. METHODS: The authors selected US participants with an age at symptom onset of 10 to 60 years, and YONSET > or = 1980 (n = 16,581). The authors divided YONSET into 5-year groups and compared DONDX between groups using multivariate Cox regression. The authors classified participants enrolled within 2 years of diagnosis (n = 5,548) as having mild, moderate, or severe disability using Patient Determined Disease Steps, and assessed the association of disability with YONSET using polytomous logistic regression. RESULTS: DONDX decreased with later YONSET (r = -0.43, p < 0.0001). This association remained after adjustment for demographic factors in a multivariate Cox model. Later YONSET was associated with increased odds of having mild disability at diagnosis as compared to severe disability (OR = 1.10 per year; 1.09 to 1.11). CONCLUSION: The delay from symptom onset to diagnosis is steadily decreasing in MS. An increasing proportion of patients with MS have mild disability at diagnosis after accounting for confounders. As the effectiveness of therapies is influenced by disease duration, this has implications for comparison of treatment effects in modern clinical trials to earlier study results.

Adolescent↗

PubMed1991

A 2-km walking test for assessing the cardiorespiratory fitness of healthy adults.

A simple walking test was developed with 159 (females = 80, males = 79) healthy 20-65-year-old subjects. All the subjects first walked the distances of 1.0, 1.5 and 2.0 km on a flat dirt road. Half of the participants were tested in the laboratory for maximal oxygen uptake (VO2max), and the 2-km test was repeated again twice. In a comparison of the three distances, the 2-km test was repeatable, the most preferable subjectively and the most accurate in predicting VO2max. A sex-specific prediction model including walking time, heart rate at the end of the walk, age and body mass index predicted 73-75% of the variance in VO2max (ml.kg-1.min-1) and that with body weight 66-76%, with a standard error of estimate of the order of 9-15% of the mean. The cross-validation of the models yielded reasonable accuracy in obese men and women and in moderately active men, and less accuracy in moderately active women and highly active men. These results suggest that a fast 2-km walk supplemented with simple measurements is a feasible and accurate alternative for determining the cardiorespiratory fitness of healthy adults.

Adult↗