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At least 721 records · Page 40Linked to original sources

Plasma protein-bound sulfhydryl group oxidation in humans following a full marathon race.

Physical exercise can induce oxidative stress in humans. We studied the influence of aerobic exercise on the status of plasma protein-bound sulfhydryl groups in seven moderately-trained male college students who participated in a full marathon race. The plasma protein-bound sulfhydryl group values were significantly declined immediately after the race (-22%, p < 0.01), and 24 h (-12%, p < 0.01) and 48 h (-13%, p < 0.01) after the race, as compared to the baseline value. The plasma concentrations of thiobarbituric acid reactive substances were unchanged following the race, while the activities of plasma creatine kinase were significantly increased, indicating skeletal muscle damage. These results suggested that prolonged exercise may cause the oxidation of plasma proteins.

Adult↗

Physiological changes in the running greyhound (Canis domesticus): influence of race length.

1. Racing greyhounds were allowed to run 402 m, 503 m, and 704 m to determine the influence of increased race length on physiological changes during and after exercise. 2. Plasma and whole blood variables that changed significantly with increased race length were [K+], [total protein], [lactate], hematocrit, and arterial pH. 3. Those variables that changed with increased race distance showed no indication of reaching a plateau; thus, the maximum changes that these variables might undergo with longer exercise duration remains unknown.

Animals↗

The prognostic significance of race and survival from prostate cancer based on patients irradiated on Radiation Therapy Oncology Group protocols (1976-1985).

A number of studies have identified race as a prognostic factor for survival from prostate cancer. To evaluate the prognostic significance of race in a controlled setting, we evaluated 1294 patients treated on three prospective randomized trials conducted by the Radiation Therapy Oncology Group between 1976 to 1985. One-hundred and twenty (9%) of the patients were coded as black, while 1077 (83%) of the patients were coded as white. Protocol 7506 included 607 patients with clinical Stage T3-T4Nx or T1b-T2N1-2. Protocol 7706 included 484 patients with clinical Stage T1b or T2 who were node negative. Protocol 8307 included 203 Stage T2b-T4 patients with no lymph node involvement beyond the pelvis. Univariate and multivariate analyses were used to assess the possible independent significance of race and other prognostic factors, including Gleason score, serum acid phosphatase, nodal status, and hormonal status. Protocols 7706 and 8307 revealed that race was not of prognostic significance for disease-free or overall survival by either univariate or multivariate analysis. Univariate analysis of Protocol 7506 revealed that the median survival for blacks was somewhat shorter (5.4 years vs. 7.1 years, p = 0.02). This difference persisted after a multivariate analysis. A higher percentage of blacks treated on 7506 had an abnormally elevated serum acid phosphatase compared to whites (p = 0.006), and the time to distant failure tended to be shorter (p = 0.07). These findings suggest that blacks treated on 7506 may have had more extensive disease at presentation. Based on these prospective randomized trials, it is most likely that the lower survival noted for black Americans with prostate cancer reflects the tendency for blacks to present with more advanced disease. Differences in access to care, the quality of care received, and the impact of co-morbid conditions may explain the lower survival reported for black Americans elsewhere in the literature.

Black or African American↗

Determination of race and sex of the human skull by discriminant function analysis of linear and angular dimensions.

The race and sex of the human skull can be determined by craniometry. In this paper we suggest that a large number of craniometric measurements does not necessarily give the best possible discrimination for race and test the performance of subsets of variables drawn from various skull regions, or extracted mathematically on the basis of their discriminatory power. We also suggest that the best discriminators for race are not necessarily the best for sex, and that skulls of unknown provenance are best tested first for race and then for sex, using different variables for each purpose.

Adult↗

Depressed autonomic nervous system function in African Americans and individuals of lower social class: a potential mechanism of race- and class-related disparities in health outcomes.

BACKGROUND: Both race and social class influence cardiovascular outcomes, through mechanisms not yet fully understood. Minority race and lower social class are sources of chronic stress, which can alter autonomic nervous system function. Heart rate variability (HRV), a measure of autonomic function, is also an important predictor of cardiovascular outcomes. METHODS: To determine whether minority race/ethnicity and lower social class are associated with depressed HRV, we prospectively collected data on sociodemographic, clinical, psychological, and behavioral factors by survey in 360 outpatients undergoing ambulatory electrocardiographic monitoring. Heart rate variability (24-hour) was measured by frequency domain analysis. RESULTS: In unadjusted analysis, African Americans had lower HRV than whites, and individuals of lower social class as measured by education, occupation, and income had lower HRV than those of higher class. In multivariable analysis, both race and social class were independent predictors of ultralow frequency power after controlling for clinical and psychological factors. African Americans were 3.45 (95% CI 1.74-6.98, P = .0004) times as likely as whites to have depressed HRV (ultralow frequency power, lowest tertile), and non-college graduates 2.94 (95% CI, 1.71-5.14, P = .0001) times as likely as college graduates to have depressed HRV. CONCLUSIONS: Heart rate variability is lower in African Americans and individuals of lower social class, independent of the effects of measured clinical, psychological, or behavioral factors. This suggests that the adverse effects of minority race and lower social class on cardiovascular outcomes may be mediated by dysregulation of autonomic function.

Adult↗

The association of race with frailty: the cardiovascular health study.

PURPOSE: Frailty, which has been conceptualized as a state of decreased physiologic reserve contributing to functional decline, has a prevalence among older African Americans that is twice that in older whites. This study assesses the independent contribution of race to frailty. METHODS: We evaluated 786 African-American and 4491 white participants of the Cardiovascular Health Study (CHS). Frailty is defined as meeting three or more of five criteria derived from CHS measures: lowest quintile for grip strength, self-reported exhaustion, unintentional weight loss of 10 lbs or greater in 1 year, slowest quintile for gait speed, and lowest quintile for physical activity. Controlling for age, sex, comorbidity, socioeconomic factors, and race, multinomial logistic regression estimated the odds ratio (OR) of prefrail (one or two criteria) to not frail and frail to not frail. RESULTS: Among African Americans, 8.7% of men and 15.0% of women were frail compared with 4.6% and 6.8% of white men and women, respectively. In adjusted models, nonobese African Americans had a fourfold greater odds of frailty compared with whites. The increased OR of frailty associated with African-American race was less pronounced among those who were obese or disabled. CONCLUSION: African-American race is associated independently with frailty.

Black or African American↗

Race (black-white) and gender divergences in the relationship of childhood cardiovascular risk factors to carotid artery intima-media thickness in adulthood: the Bogalusa Heart Study.

It has been established that childhood cardiovascular (CV) risk factors are predictive of adulthood vascular changes as measured by carotid intima-media thickness (IMT). However, whether this relationship is race- and gender-specific is not known. This aspect was examined in a black-white cohort of 868 adults (29% blacks, 42% males) aged 25-44 years who were examined at least twice in childhood for traditional CV risk factors with an average follow-up period of 26.4 years. The average value of the two earliest childhood measurements was used as the childhood value, standardized to age, race, and gender-specific z-score. Carotid IMT was measured by B-mode ultrasonography. The mean of the maximum carotid IMT readings of three right and three left far walls for common, bulb and internal segments was used. In univariate analysis, significant correlates of adulthood carotid IMT (standardized to age-, race- and gender-specific z-score) were, in the order of decreasing magnitude, triglyceride and LDL cholesterol in white males; systolic blood pressure, LDL cholesterol, and body mass index (BMI) in white females; systolic blood pressure in black males; BMI and systolic blood pressure in black females. In multivariate regression analysis, significant predictors of carotid IMT were triglycerides and LDL cholesterol in white males; systolic blood pressure and LDL cholesterol in white females; systolic blood pressure in black males; and BMI and LDL cholesterol in black females. In conclusion, the predictability of childhood CV risk factors for increased carotid IMT in adulthood varies by race and gender. The prevention implications of these findings need further investigation.

Adolescent↗

Comparison of medication adherence and associated health care costs after introduction of pioglitazone treatment in African Americans versus all other races in patients with type 2 diabetes mellitus: a retrospective data analysis.

OBJECTIVE: The aim of this study was to compare treatment adherence and health care costs in African Americans versus all other races (All Others) in patients with type 2 diabetes mellitus starting treatment with pioglitazone. METHODS: In this retrospective cohort study, the North Carolina Medicaid database was used (query dates: July 1, 2000, to June 30, 2003). Using at least 1 code from the International Classification of Diseases, Ninth Revision, Clinical Modification for type 2 diabetes (250.xx) and 1 National Drug Code for antidiabetic medication, we identified a cohort of male and female patients aged > or =18 years with type 2 diabetes who maintained continuous Medicaid eligibility for the entire 36-month follow-up period. Race was categorized as African American and All Others (white, Asian, Native American, Pacific Islander, other) based on self-reported data collected at the time of Medicaid enrollment. Medication adherence was expressed as medication possession ratio (calculated as the number of days of antidiabetic prescription supply dispensed [eg, a 30-day supply] divided by the number of days between the first and last dispensation). Reimbursements made by Medicaid were used to calculate diabetes-related and total health care costs, which included medical and dental care, including costs for regular checkups, office visits, home health care, inpatient and outpatient care, long-term care facility care, and prescription drugs. To compare the differences in medication adherence and annual total and diabetes-related health care costs between African Americans and All Others, multivariate regression analysis was performed using only data from the year after (year 2) the year in which pioglitazone treatment was started (year 1). RESULTS: Among the 1073 patients treated with pioglitazone (26.1% men; mean [SD] age, 49.5 [10.6] years; 50.2% African American; mean [SD] total health care costs in year 1, US $7906 [$12,256]; year 2, $9546 [$14,861]), African Americans had significantly higher adherence (62%) to pioglitazone treatment compared with All Others (57%) (P < 0.05) on unadjusted analysis. However, no significant differences in rates of adherence to the medication were found between African Americans and All Others on multivariate regression analysis. African American race was not found to be an independent predictor of increased or decreased annual total health care costs in this population. Significant reductions in total health care costs (2% for every 10% increase in adherence; P < 0.001) and diabetes-related costs (4% for every 10% increase in adherence; P < 0.01) with increased adherence were found. CONCLUSIONS: On multivariate analysis, this study found no significant differences in treatment adherence between African Americans versus all other races in this population of diabetic patients enrolled in a Medicaid program (query dates: July 1, 2000, to June 30, 2003). A higher adherence rate was associated with significantly lower diabetes-related and total health care costs in this population.

Adult↗

Parental race, birth weight, gestational age, and fetal growth among twin infants in the United States.

BACKGROUND: No previous study has examined the association between paternal race and birth weight among twins. AIMS: To examine the association of parents' race and birth weight among twins. STUDY DESIGN: Population-based retrospective cohort study to examine the association between parents' race and birth weight, and its two components, gestation duration and fetal growth among four group of infants: both parents blacks (FB-MB), father white and mother black (FW-MB), father black and mother white (FB-MW), and both parents whites (FW-MW), with "risk-free" analysis to control confounding factors. SUBJECTS: Twin births (304,466 twins) registered in the United States in 1995-1997. OUTCOME MEASURES: The means of birth weight, gestational age, and birth-weight-for-gestational age z score, and rates of very low birth weight (VLBW, <1500 g), very preterm birth (VPTB, <32 weeks of gestation), and fetal growth restriction (FGR, <10th percentile of z score). RESULTS: Means of birth weight, gestational age, and z score were 2234.0, 2301.9, 2361.1, and 2433.8, and 35.02, 35.24, 35.65, and 35.78, and -0.136, -0.070, -0.039, and 0.063, respectively, and the rates of VLBW, VPTB, and FGR were 14.5, 12.3, 10.5, and 8.1, and 16.0, 13.0, 11.6, and 9.2, and 12.6, 11.1, 10.8, and 8.7, respectively, in the FB-MB, FW-MB, FB-MW, and FW-MW groups. Excluding subjects with various risk factors by risk-free analysis did not change the results. CONCLUSIONS: Both parents' races are important determinants of birth weight, gestational age, and fetal growth among twin pregnancies, with higher effect on gestational age and greater maternal influence than paternal influence.

Adult↗

Association of race and gender with general surgeons' annual incomes.

BACKGROUND: Specialty, work effort, and gender have been shown to be associated with physicians' annual incomes. Although female plastic, oral, and cardiothoracic surgeons have been shown to have lower incomes than their male counterparts, differences in incomes attributable to gender or race among general surgeons have not been evaluated. STUDY DESIGN: We used survey responses collected during the 1990s from 771 actively practicing general surgeons and linear regression modeling to determine the association of race and gender with general surgeons' annual incomes after controlling for work effort, provider characteristics, and practice characteristics. RESULTS: Compared with Caucasian men, both African-American male and Caucasian female general surgeons reported having fewer patient visits (10% fewer and 17% fewer, respectively), but working more annual hours (14% more and 6.7% more, respectively). Caucasian women were more likely than the other groups to be nonpractice-owner employees. African-American men and Caucasian women were less likely than their Caucasian male counterparts to be board certified. After adjustment for work effort, provider characteristics, and practice characteristics, African-American men's mean annual income was $248,048, or $49,205 (17%) lower than that for Caucasian men (95% CI: $129,645 lower to $31,236 higher, p=0.2); Caucasian women's was $233,397, or $63,856 (21%) lower (95% CI: $120,367 to $7,345 lower, p=0.03). CONCLUSIONS: During the 1990s, among Caucasian general surgeons, female gender was associated with considerably lower annual incomes; among male general surgeons, African-American race was associated with lower annual incomes, but not substantially so. These findings warrant additional exploration to ensure that income differences among physicians are not unjustly determined by race or gender.

Black or African American↗

The intra-push velocity profile of the over-ground racing wheelchair sprint start.

The aim of this study was to analyse the first six pushes of a sprint start in over-ground racing wheelchair propulsion. One international male wheelchair athlete (age=28 years; body mass=60.6 kg; racing classification=T4) performed maximal over-ground sprint trials, over approximately 10 m, in his own racing wheelchair fitted with a velocometer. Each trial was filmed at 200 Hz using a "Pan and Tilt" system. Eight trials were manually digitised at 100 Hz. Raw co-ordinate data were smoothed and differentiated using a quintic spline routine. Across the period from pushes one to six the duration of each push cycle decreased (0.82+/-0.02-0.45+/-0.01 s) with the mean duration of the propulsive phase decreasing from 0.62+/-0.02 to 0.21+/-0.01 s and the recovery phase increasing from 0.20+/-0.01 to 0.24+/-0.02 s. The push-rim was contacted progressively closer to top dead centre and released progressively closer to bottom dead centre with each push. The data indicate that peak velocity occurred after release. The main findings of this study support the observation that racing wheelchair sprint propulsion is a complex form of locomotion and cannot be described accurately by using just the established definitions of a propulsive and a recovery phase.

Acceleration↗

Do race, gender, and source of payment impact on anesthetic technique for inguinal hernia repair?

STUDY OBJECTIVE: To evaluate the potential differences in the type of anesthesia provided to patients of different race, gender, and source of payment undergoing inguinal hernia repair (IHR). DESIGN: Retrospective cohort study. SETTING: Ambulatory surgical centers/National Survey of Ambulatory Surgery. PATIENTS: 5810 patients older than 14 years who underwent IHR in an ambulatory surgical center. INTERVENTIONS: Inguinal hernia repair under different types of anesthesia. MEASUREMENTS: The association of race, gender, and source of payment with different types of anesthesia for IHR as determined by multivariate regression analysis. RESULTS: Significant discrepancies in the use of various anesthetics between patients of different race, gender, and source of payment were found. Patients identified as black and those of other minority groups were significantly more likely to receive general anesthesia compared with those identified as white (odds ratio [OR] 2.76, confidence interval [CI] 1.96-3.88 and OR 1.66, CI 1.14-2.42, respectively). Those identified as black were less likely to receive epidural anesthesia compared with their white counterparts (OR 0.36, CI 0.14-0.95). Women were less likely than men to undergo IHR with epidural anesthesia (OR 0.5, 95% CI 0.3-0.85). CONCLUSION: Significant discrepancies in the use of various anesthetics for IHR between patients of different race, gender, and insurance status were found. Despite limitations inherent to secondary data analysis, the findings raise the possibility that nonmedical factors may influence anesthetic management.

Adolescent↗

Normative standards for vocal tract dimensions by race as measured by acoustic pharyngometry.

SUMMARY: Acoustic pharyngometry evaluates the geometry of the vocal tract with acoustic reflections and provides information about vocal tract cross-sectional area and volume from lip to the glottis. Variations in vocal tract diameters are needed for speech scientists to validate various acoustic models and for medical professionals since the advent of endoscopic surgical techniques. Race is known to be one of the most important factors affecting the oral and nasal structures. This study compared vocal tract dimensions of White American, African American, and Chinese male and female speakers. One hundred and twenty healthy adult subjects with equal numbers of men and women were divided among three races. Subjects were controlled for age, gender, height, and weight. Six dimensional parameters of the speakers' vocal tract cavities were measured with acoustic reflection technology (AR). Significant gender and race main effects were found in certain vocal tract dimensions. The findings of this study now provide speech scientists, speech-language pathologists, and other health professionals with a new anatomical database of vocal tract variations for adult speakers from three different races.

Adult↗

Race and socioeconomic differences in post-settlement outcomes for African American and Caucasian Workers' Compensation claimants with low back injuries.

The purpose of this study was to predict post-settlement pain intensity, psychological distress, disability, and financial struggle among African American (n=580) and non-Hispanic Caucasian (n=892) Workers' Compensation claimants with single incident low back injury. The study was a population-based telephone survey conducted in three population centers in Missouri. Post-settlement outcomes were predicted from claimant demographics (race, age, gender); socioeconomic status (SES); diagnosis and legal representation; and Workers' Compensation resolution variables (treatment costs, temporary disability status, disability rating, settlement costs). Simultaneous-entry, hierarchical multiple linear regression analyses indicated that African American race and lower SES predicted higher levels of post-settlement pain intensity, psychological distress (general mental health, pain-related catastrophizing), disability (pain-related role interference), and financial struggle, independent of age, gender, diagnosis, legal representation, and Workers' Compensation resolution variables. The results suggest that African American race and lower SES-relative to Caucasian race and higher SES-are risk factors for poor outcomes after occupational low back injury. Mechanisms to explain these associations are discussed, including patient-level, provider-level, legal, and Workers' Compensation system-level factors.

Adolescent↗

A multilevel analysis of race, community disadvantage, and body mass index among adults in the US.

This study examined the contributions of both individual socioeconomic status (SES) and community disadvantage in explaining the higher body mass index (BMI) of black adults in the US. Data from a national survey of adults (1986 American's Changing Lives Study) were combined with tract-level community data from the 1980 census. Results of multilevel regression analyses showed that black women had an age-adjusted BMI score three points higher than non-black women. Individual SES (income, education, assets) was negatively associated with BMI in women, but it only reduced the association between race and BMI from 2.99 to 2.50. Adding community socioeconomic disadvantage index further reduced the race coefficient slightly from 2.50 to 2.21. Nevertheless, living in communities with higher socioeconomic disadvantage was associated with higher BMI net of age, race, individual SES, smoking, physical activity, stress, and social support. Community income inequality (Gini) had an independent positive association with BMI, but did not substantially reduce racial differences among women. Community percent black was not associated with BMI. Results for men demonstrated no statistically significant racial differences in BMI, and no association between BMI and either individual SES or community disadvantage. Although individual SES and community socioeconomic disadvantage each partly explained the higher average BMI among black women, clear racial disparities persisted. Moreover, race, individual SES, community socioeconomic disadvantage, and individual health behaviors were each independent predictors of BMI among women. Unexplained within- and between-community variance in BMI remained among both women and men, with most unexplained variation due to within-community variance. Because our evidence for women suggests that the determinants of obesity are multiple and multilevel, attempts to address this growing social problem will similarly require a multi-faceted and multilevel approach.

Adult↗

Race and sex differences in the management of coronary artery disease.

Although numerous studies have documented race and sex differences in the treatment of coronary artery disease, the available analyses have not been comprehensively evaluated. In this review, we summarize prior estimates of race and sex disparities in the utilization of standard tests and therapies, and we evaluate studies of factors that may contribute to gaps in care. The studies presented consistently demonstrate that blacks and women with coronary artery disease, compared with whites and men, are substantially less likely to receive standard interventions. Studies also indicate that racial differences relate in part to socioeconomic factors, process-of-care variables, and patient preferences, whereas sex differences relate in part to clinical factors. In both cases, however, our understanding is limited by deficiencies in currently available datasets. Moreover, factors that have been shown to contribute to race and sex disparities in medical care fail to explain them fully. In both cases, physician decision-making appears to contribute as well, suggesting that subconscious biases may contribute to treatment disparities. We conclude by proposing initiatives to remedy race and sex disparities in medical care. Efforts should focus on increasing physician awareness of this problem. Studies should gather data that are currently unavailable for analysis, including detailed clinical variables and patient-level socioeconomic information. Finally, novel quality assurance programs, designed to evaluate and improve the care of blacks and women with coronary artery disease, should be promptly undertaken.

Black People↗

Influence of race and gender on care process, resource use, and hospital-based outcomes in congestive heart failure.

Race and gender are important determinants of certain clinical outcomes in cardiovascular disease. To examine the influence of race and gender on care process, resource use, and hospital-based case outcomes for patients with congestive heart failure (CHF), we obtained administrative records on all 1995 New York State hospital discharges assigned ICD-9-CM codes indicative of this diagnosis. The following were compared among black and white women and men: demographics, comorbid illness, care processes, length of stay (LOS), hospital charges, mortality rate, and CHF readmission rate. We identified 45,894 patients (black women, 4,750; black men, 3,370; white women, 21,165; white men, 16,609). Blacks underwent noninvasive cardiac procedures more often than whites; procedure and specialty use rates were lower among women than among men. After adjusting for other patient characteristics and hospital type and location, we found race to be an important determinant of LOS (black, 10.4 days; white, 9.3 days; p = 0.0001), hospital charges (black, $13,711; white, $11,074; p = 0.0001), mortality (black-to-white odds ratio = 0.832; p = 0.003), and readmission (black-to-white odds ratio = 1.301; p = 0.0001). Gender was an important determinant of LOS (women, 9.8 days; men, 9.2 days; p = 0.0001), hospital charges (women, $11,690; men, $11,348; p = 0.02), and mortality (women-to-men odds ratio = 0.878; p = 0.0008). We conclude that race and gender influence care process and hospital-based case outcomes for patients with CHF.

Adult↗

Age, race, and sex differences in autonomic cardiac function measured by spectral analysis of heart rate variability--the ARIC study. Atherosclerosis Risk in Communities.

To investigate the distribution of heart rate variability (HRV) spectral power in an unselected sample of the population, and to ascertain the population correlates of HRV, we examined 1,984 healthy persons, aged 45 to 64 years, randomly selected from the Atherosclerosis Risk in Communities (ARIC) study cohort. Resting, supine, 2-minute, beat-to-beat heart rate data were collected between 7 A.M. and 12 noon. The race- and sex-adjusted geometric means of low-frequency component (LF, 0.025 to 0.15 Hz) were 4.00 and 3.13 (beats/min)2; of high-frequency component (HF, 0.16 to 0.35 Hz), 1.65 and 1.21 (beats/min)2; and of the HF/LF ratio, 0.41 and 0.39, for 45-to-54 and 55-to-64 years age groups, respectively (test of mean difference by age, p < 0.01, p < 0.01, and p = 0.11 for LF, HF, and HF/LF ratio, respectively). Comparing black with white examinees, the age- and sex-adjusted geometric means of LF were 3.06 and 3.70 (beats/min)2; of HF, 1.66 and 1.36 (beats/min)2; of HF/LF, 0.54 and 0.37, respectively (test of mean difference by race, p < 0.01, p < 0.01, and p < 0.01). The age- and race-adjusted geometric means of LF for women and men were 3.12 and 4.10 (beats/min)2; of HF, 1.46 and 1.38 (beats/min)2; and of HF/LF, 0.47 and 0.34, respectively (test of mean difference, p < 0.01, p = 0.34, and p < 0.01). We conclude that HRV spectral indexes are associated with age, race, and sex. With increasing age, the parasympathetic and sympathetic spectral power components decrease.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗