Ascertainment of Hispanic ethnicity on California death certificates: implications for the explanation of the Hispanic mortality advantage.

Objectives: We determined the size and correlates of underascertainment of Hispanic ethnicity on California death certificates.

Methods: We used 1999 to 2000 vital registration data. We compared Hispanic ethnicity reported on the death certificate to Hispanic ethnicity derived from birthplace for the foreign-born and an algorithm that used first and last name and percentage of Hispanics in the county of residence for the US-born.

Handgrip strength and cognitive decline in older Mexican Americans.

Background: Cognitive decline and dementia are associated with disability and premature death in old age. We examined whether low handgrip strength predicts subsequent cognitive decline in older Mexican Americans.

Methods: We worked with a 7-year prospective cohort of 2160 noninstitutionalized Mexican Americans aged 65 years or older from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE) who had a Mini-Mental State Examination (MMSE) score > or = 21 at baseline.

Determinants of androgen deprivation therapy use for prostate cancer: role of the urologist.

Background: The use of androgen deprivation therapy for prostate cancer has been increasing, even in settings for which there is weak or no evidence of efficacy. This pattern suggests that factors other than the typical patient and tumor characteristics may be driving its use. We assessed the importance of the physician as a determinant of the use of androgen deprivation therapy in prostate cancer in a population-based, retrospective cohort study using the Surveillance, Epidemiology and End-Results-Medicare linked database.

Use and outcomes of adjuvant chemotherapy in older women with breast cancer.

Purpose: This study was undertaken to determine patterns and outcomes of adjuvant chemotherapy use in a population-based cohort of older women with primary breast cancer.

Patients And Methods: Women were identified from the Surveillance, Epidemiology, and End Results-Medicare-linked database who met the following criteria: age > or = 65 years, stage I to III breast cancer, and diagnosis between 1991 and 1999. Adjuvant chemotherapy use was ascertained by Common Procedural Terminology J codes.

Late gastrointestinal toxicity after radiation for prostate cancer.

Background: The current study was designed to determine rates and predictors of late, lower gastrointestinal toxicity after radiation therapy in a population-based cohort of older men with prostate cancer.

Methods: The study population consisted of men with localized or regional stage prostate cancer who were age > or =66 years and were diagnosed between 1992 and 1999 who were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Gastrointestinal diagnoses were ascertained through claims from 6 to 60 months after diagnosis.

Impact of a scientific presentation on community treatment patterns for primary breast cancer.

Background: The publication of results from randomized clinical trials can have a dramatic effect on treatment patterns, but the impact of oral presentations at national scientific meetings is unknown. We investigated the temporal association between the oral presentation of the results from the Cancer and Leukemia Group B (CALGB) Study 9344 at the May 1998 meeting of the American Society of Clinical Oncology, which showed that paclitaxel improves survival of women with lymph node-positive breast cancer, and use of taxane chemotherapy for breast cancer.

Methods: We studied chemotherapy use in 3341 women identified through the Surveillance, Epidemiology, and End Results-Medicare database who were diagnosed with stage I-III breast cancer in 1994-1999 at age 65 years or older and received adjuvant chemotherapy, as identified through claims data, within 1 year of diagnosis.

Examination of follow-up therapy in patients with stroke.

Objective: Examine the patterns and effect of follow-up therapy for persons with stroke.

Design: Retrospective analysis of national inpatient medical rehabilitation facilities and follow-up survey data from 1994 to 2001. A total of 45,164 patients received inpatient medical rehabilitation after a stroke.

Risk of the "androgen deprivation syndrome" in men receiving androgen deprivation for prostate cancer.

Background: Androgen deprivation therapy for prostate cancer has been associated with a spectrum of adverse effects, such as depression, memory difficulties, and fatigue, termed the androgen deprivation syndrome. Primary care physicians providing follow-up care for men with prostate cancer will be faced with managing these effects. We therefore sought to estimate the incidence of these effects and, by using a control group, ascertain whether these effects were related to androgen deprivation itself.

Cardiac morbidity of adjuvant radiotherapy for breast cancer.

Purpose: Adjuvant breast irradiation has been associated with an increase in cardiac mortality, because left-sided breast radiation can produce cardiac damage. The purpose of this study was to determine whether modern adjuvant radiotherapy is associated with increased risk of cardiac morbidity.

Patients And Methods: Data from the Surveillance, Epidemiology, and End Results-Medicare database were used for women who were diagnosed with nonmetastatic breast cancer from 1986 to 1993, had known disease laterality, underwent breast surgery, and received adjuvant radiotherapy.

Cognitive status, muscle strength, and subsequent disability in older Mexican Americans.

Objectives: To examine the association between Mini-Mental State Examination (MMSE) score and subsequent muscle strength (measured using handgrip strength) and to test the hypothesis that muscle strength will mediate any association between impaired cognition and incident activity of daily living (ADL) disability over a 7-year period in elderly Mexican Americans who were initially not disabled.

Design: A 7-year prospective cohort study (1993-2001).

Setting: Five southwestern states (Texas, New Mexico, Colorado, Arizona, and California).

Screening for cognitive impairment in older adults attending an eye clinic.

Purpose: We conducted a cross-sectional study examining potentially modifiable factors associated with cognitive impairments (mild or severe) in older whites, African Americans and Hispanics attending an outpatient eye clinic.

Methods: In-clinic interviews and physical examinations assessed social, demographic and health information from 100 consecutive Hispanic, African-American and white adults aged > or = 55. Our primary outcome was presence of any cognitive impairment (mild or severe) using the St.

How do nurse case managers care for older women with breast cancer?

Purpose/objectives: To describe how nurse case managers care for older women with breast cancer.

Design: A randomized, prospective trial.

Setting: Thirteen community hospitals and two public hospitals in southeastern Texas.

Ethnic differences in herb and vitamin/mineral use in the elderly.

Background: Little information exists on herb and vitamin-mineral supplement use in very old people and whether use varies by ethnicity.

Objective: To examine the prevalence and predictors of herb and vitamin-mineral supplement use in a tri-ethnic sample of adults aged > or = 77 years.

Methods: In-home interviews in 1997-1998 assessed medications use and sociodemographic and health factors in community-dwelling elderly non-Hispanic white (n = 125), black (n = 112), and Hispanic (n = 128) adults.

Near vision impairment predicts cognitive decline: data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly.

Objectives: To estimate the association between sensory impairment and cognitive decline in older Mexican Americans.

Design: A prospective cohort study.

Setting: The Hispanic Established Populations for Epidemiologic Studies of the Elderly from five southwestern states.

The association of marital status and hospice use in the USA.

Background: Married individuals are more likely to use hospice than unmarried individuals. We examine this association and how it is influenced by gender.

Methods: Medicare beneficiaries dying of cancer were studied.

Risk of cardiac death after adjuvant radiotherapy for breast cancer.

Background: Women with breast cancer who are treated with adjuvant radiation have a decreased risk of local recurrence but an increased risk of mortality from ischemic heart disease. Patients with left-sided breast tumors receive a higher dose of radiation to the heart than patients with right-sided tumors. Because radiation techniques have improved over time, we investigated whether the risk of death from ischemic heart disease after adjuvant breast radiotherapy decreased over time.

Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma.

Background: The role of androgen deprivation therapy in prostate carcinoma is controversial in earlier stages of disease. The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin-releasing hormone (GnRH) agonists or orchiectomy, in population-based tumor registries.

Methods: Data were obtained from the linked Surveillance, Epidemiology and End Results-Medicare database.

Hepatitis B vaccination in human immunodeficiency virus-infected adults receiving hemodialysis.

Background: The Centers for Disease Control and Prevention (CDC) recommends hepatitis B virus (HBV) immunization for all hemodialysis (HD) patients because they are at high risk of infection. Several studies have shown that the development of protective antibody titers after HBV vaccination is much lower in HD patients. We hypothesized that human immunodeficiency virus (HIV) infection in patients with end-stage renal disease (ESRD) would further impair the immune response to hepatitis B vaccination.

Relationship of depression to patient satisfaction: findings from the barriers to breast cancer study.

Objective: Examine the association between depressive symptoms and patient satisfaction for older women with a diagnosis of breast cancer.

Methods: Prospective study of 210 women aged 65 or older from southeast Texas newly diagnosed with breast cancer. Baseline (<2 months after diagnosis) and 12 month follow-up interviews were conducted face-to-face to collect information on sociodemographic characteristics, physical and emotional health, use of health services and satisfaction with medical care.

Risk of fracture after androgen deprivation for prostate cancer.

Background: The use of androgen-deprivation therapy for prostate cancer has increased substantially over the past 15 years. This treatment is associated with a loss of bone-mineral density, but the risk of fracture after androgen-deprivation therapy has not been well studied.

Methods: We studied the records of 50,613 men who were listed in the linked database of the Surveillance, Epidemiology, and End Results program and Medicare as having received a diagnosis of prostate cancer in the period from 1992 through 1997.

Hospice use by Hispanic and non-Hispanic white cancer decedents.

Objective: To investigate rates of hospice use between Hispanic and non-Hispanic white Medicare beneficiaries diagnosed with cancer using data from a large, population-based study.

Data Sources: Secondary data from the linked SEER-Medicare database including the SEER areas of Los Angeles, San Francisco, and San Jose-Monterey, California, and the state of New Mexico. All subjects were Hispanic or non-Hispanic whites, aged 67 and older, had a cancer diagnosis of breast, colorectal, lung, or prostate cancer from 1991-1996, and died of cancer from 1991-1998.

Hospitalization for initiation of maintenance hemodialysis.

Background: Recent data on complications of hemodialysis (HD) is lacking. With advancement in dialysis technology the incidence of complications such as dialysis disequilibrium syndrome (DDS) has decreased. Notwithstanding these improvements many patients with end-stage renal disease (ESRD) continue to be hospitalized solely for initiation of hemodialysis.

Health-related social disengagement in elderly diabetic patients: association with subsequent disability and survival.

Objective: We examined the relationship between health-related social disengagements, as opposed to disengagements related to financial and other non-health-related factors, and subsequent risk of disability and death among initially nondisabled elderly diabetic patients enrolled in Medicare Managed Care plans.

Research Design And Methods: We used data from the Medicare Health Outcomes Survey (HOS) Cohort 1 Baseline (1998) and Cohort 1 Follow-Up (2000). Through mail and telephone surveys, trained interviewers collected information on sociodemographic variables, physical and mental health functioning (using Medical Outcomes Study Short Form-36 [SF-36]), activities of daily living (ADL), and medical conditions.

Risk of malignancy with long-term immunosuppression in renal transplant recipients.

Background: Improvements in immunosuppressive regimens have significantly enhanced patient and graft survival in renal transplant recipients. However, susceptibility to neoplastic disorders is increased as a consequence of prolonged immunosuppression. Available data pertaining to cancer risks in renal transplant recipients have been inconsistent, and much of it is derived from international studies, which may not be truly representative of the United States population.

HIV-associated nephropathy and end-stage renal disease in children in the United States.

Single-center studies have reported that HIV-associated nephropathy (HIVAN) can occur in children and may have a clinical course and prognosis similar to that of adults. However, the prevalence and survival has not been reported for a national sample of children with HIVAN and end-stage renal disease (ESRD) on dialysis in the United States. We utilized the United States Renal Data System (USRDS) database to determine the prevalence, demographic information, and survival of children with HIVAN and ESRD in the United States.