Medicine and Health Sciences Commons^™

What Is The Cost To Employers Of Direct Medical Care For Chronic Obstructive Pulmonary Disease?, Tursynbek Nurmagambetov, Adam Atherly, Seymour Williams, Fernando Holguin, David M. Mannino, Stephen C. Redd

David M. Mannino

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the United States. In 2000, an estimated 10.5 million people had COPD, of which more than 7.2 million were from the under-age 65 employed population. The prevalence of COPD in the workforce population was substantial with 46.5% of current employment among adults having the disease. However, the cost burden in the employed population is unknown. We examined COPD prevalence and costs in a large employment-based population. Using claims data from 1999 to 2003, we estimated the cost associated with COPD-related hospitalizations, emergency department visits, outpatient services, …

The Effect Of Timing Of Radiotherapy After Breast-Conserving Surgery In Patients With Positive Or Close Resection Margins, Young Age, And Node-Negative Disease, With Long Term Follow-Up, Olga Vujovic, Anil Cherian, Edward Yu, A. Dar, Larry Stitt, Francisco Perera

Edward Yu

Purpose: The aim of this study was to determine the effect of timing of radiotherapy after conservative breast surgery on local recurrence in women with positive resection margins and young age, treated without systemic therapy. Methods and materials: A total of 568 patients with T1 and T2, N0 breast cancer were treated with breast-conserving surgery and breast irradiation, between January 1, 1985, and December 31, 1992, at the London Regional Cancer Centre. 63 patients (11.1%) had positive/close resection margins (< 2 mm) and 48 patients (8.4%) were age < or = 40 years. For patients with positive resection margins, the time intervals from breast surgery to breast irradiation used for analysis were, 0 to 8 weeks, > 8 to 12 weeks and > 12 weeks. For patients < or = 40 years, the intervals used for analysis were 0 to 8 weeks and > 8 weeks. Results: Median follow up was 11.2 years. For patients …

Changing The Burden Of Copd Mortality, David M. Mannino, Victor A. Kiri

David M. Mannino

COPD is a major cause of mortality and morbidity worldwide with an estimated 2.75 million deaths in 2000 (fourth leading cause of death). In addition to the considerable morbidity and mortality associated with COPD, this disease incurs significant healthcare and societal costs. Current COPD guidelines acknowledge that the following can improve COPD mortality: smoking cessation; long-term oxygen therapy; and lung volume reduction surgery in small subsets of COPD patients. To date, no randomized controlled trials have demonstrated an effect of pharmacological treatment on mortality, although several observational studies suggest that both long-acting bronchodilators and inhaled corticosteroids may provide a survival …

The Role Of Body Mass Index And Diabetes In The Development Of Acute Organ Failure And Subsequent Mortality In An Observational Cohort, Katarina Slynkova, David M. Mannino, Greg S. Martin, Richard S. Morehead, Dennis E. Doherty

David M. Mannino

Introduction

Several studies have shown a correlation between body mass index (BMI) and both the development of critical illness and adverse outcomes in critically ill patients. The goal of our study was to examine this relationship prospectively with particular attention to the influence of concomitant diabetes mellitus (DM).

Methods

We analyzed data from 15,408 participants in the Atherosclerosis Risk in Communities (ARIC) study for this analysis. BMI and the presence of DM were defined at baseline. We defined 'acute organ failure' as those subjects who met a standard definition with diagnostic codes abstracted from hospitalization records. Outcomes assessed included the …

Hospitalization For Patients With Sarcoidosis: 1979-2000, M. G. Foreman, David M. Mannino, L. Kamugisha, G. E. Westney

David M. Mannino

BACKGROUND AND AIM:

Sarcoidosis is a multi-system granulomatous disease of unknown etiology with significant racial and gender differences in disease severity, incidence, and prevalence. Primarily treated in outpatients, limited information is available on hospital outcomes in patients with sarcoidosis. The National Hospital Discharge Survey (NHDS) was analyzed over a 22-year period to determine trends in hospitalization and the impact of concurrent comorbidities.

METHODS:

Secondary analysis was done of the NHDS, a national survey of inpatient medical care for short stays in nonfederal facilities.

RESULTS:

There were a total of 750 million hospitalizations over this 22-year period, with 593,455 (0.08%) hospitalizations …

Injury Prevalence Among Children And Adolescents With Mental Retardation, Elspeth M. Slayter, Deborah W. Garnick, Joanna M. Kubisiak, Christine E. Bishop, Daniel M. Gilden, Rosemarie B. Hakim

Elspeth Slayter

Anomalia Anorretal: Relato De Caso Clínico / Anorectal Malformations: A Case Report, Everton Fernando Alves, Jucélia Lins Dos Santos Oliveira, Maria Do Rosário Martins

Everton Fernando Alves

A Anomalia Anorretal é uma importante causa de obstrução gastrintestinal, com alta taxa de morbi-mortalidade em recém-natos. Há diversos mecanismos patológicos possíveis para explicar esta malformação e duas explicações clássicas de sua gênese são um defeito de recanalização do tubo intestinalou uma interrupção no suprimento sanguíneo durante a vida intra-uterina, entretanto a causa ainda é desconhecida. Desta forma, o presenteestudo tem por objetivo descrever um caso clínico de uma criança internada em um Hospital do Município de Maringá-PR, portadora de uma anomalia anorretal (Ânus imper-furado). Para este estudo, foram coletados dados do prontuário da criança, exame físico e uma entrevista …

Air Pollutants And Respiratory Symptoms Among Adults, Paulo A. Lotufo

Paulo A Lotufo

Air pollutants are associated with adverse respiratory effects mainly in susceptible groups such as children, elderly people and people with pre-existent respiratory disease. This study was designed to assess the impact of the inorganic composition of particulate matter on 33 adult asthmatics respiratory functions in São Paulo city, Brazil. From May to July 2002, fine and coarse particulate matter fractions were collected and trace metals (Fe2+, Mn2+, Zn2+, Pb2+, Cu2+) and major ions (Na+, Mg2+, K+, Ca2+, NH4 +, Cl-, NO3-, SO42-) composition was determined in each aqueous-extract fraction by Atomic Absorption Spectrometry with Graphite Furnace (AAS-GF) and Ion Chromatography, …

The Acute-Phase Proteins Serum Amyloid A And C Reactive Protein In Transudates And Exudates, Paulo A. Lotufo

Paulo A Lotufo

The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10±0.13. For comparison, the exudate/serum ratio for CRP …

Epidemiological Studies In The Information And Genomics Era: Experience Of The Clinical Genome Of Cancer Project In São Paulo, Brazil, V Wunsch, Jose Eluf-Neto, Paulo A. Lotufo, Marco A. Zago

Paulo A Lotufo

No abstract provided.

The Role Of Radiation Therapy On Medically Inoperable Clinically Localized Non-Small Cell Lung Patients: London Regional Cancer Program (Lrcp) Clinical Experience, Michael Lee, Edward Yu, Robert Ash, Patricia Tai, Larry Stitt, George Rodrigues, Rashid Dar, Mark Vincent, Richard Inculet, Richard Malthaner

Edward Yu

Lung cancer is the most frequent cause of cancer death in both men and women in North America. In 2006, an estimated 22,700 Canadians will be diagnosed with lung cancer and 19,300 will die of it (Canadian Cancer Statistics 2006). Approximately 15-20% of NSCLC patients present with early or localized disease. Surgical resection of T1-2N0 NSCLC remains the treatment of choice for this population, and results in a 5-year survival rate of 50-70%. Patients deemed medically inoperable have been treated with non-surgical therapies, such as radiation therapy(RT), while some patients have simply been observed without any tumor therapy because of …

Human Rights Abuse And Other Criminal Violations In Port-Au-Prince, Haiti: A Random Survey Of Households, Royce Hutson, Athena Kolbe

Royce A. Hutson

Reliable evidence of the frequency and severity of human rights abuses in Haiti after the departure of the elected president in 2004 was scarce. We assessed data from a random survey of households in the greater Port-au-Prince area. Methods Using random Global Positioning System (GPS) coordinate sampling, 1260 households (5720 individuals) were sampled. They were interviewed with a structured questionnaire by trained interviewers about their experiences after the departure of President Jean-Bertrand Aristide. The response rate was 90·7%. Information on demographic characteristics, crime, and human rights violations was obtained. Findings Our findings suggested that 8000 individuals were murdered in the …

Additional Cardiovascular Risk Factors Associated With Excess Weigth In Children And Adolescents. The Belo Horizonte Heart Study, Paulo A. Lotufo

Paulo A Lotufo

OBJECTIVE: To examine the association of overweight and obesity with physical activity, blood pressure (BP) and serum lipid profiles. METHODS Epidemiologic investigation of 1,450 students, between the ages of 6 and 18, in the city of Belo Horizonte, MG. Data: weight, height, BP, skinfold thickness, waist circumference, physical activity, total cholesterol (TC), LDL-c, HDL-c, and dietary habits. RESULTS The prevalence rates for overweight and obesity were 8.4% and 3.1%, respectively. In relation to the students in the lower quartile (Q1) of the distribution of subscapular skinfold, the students in the upper quartile (Q4) presented a 3.7 times higher risk (odds …