Medicine and Health Sciences Commons^™

Clinical Outcomes For Impella Procedure In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Sonika Vatsa, Kyrillos Girgis, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

The Impella, a vital ventricular assist device, has seen extensive use in managing severe heart failure and cardiogenic shock. However, the impact of this procedure on older individuals remains poorly understood. To address this gap, we scrutinized the National Inpatient Sample Database from 2019 to 2020 to elucidate in-hospital outcomes among older patients who underwent the Impella procedure. Among the 8233 patients who underwent Impella insertion, 1389 (16.8%) were in the older population, aged 80 years or older. This subgroup exhibited a higher prevalence of comorbidities such as hypertension, diabetes mellitus, and chronic kidney disease compared to younger patients. Alarmingly, …

The Effects Of Sleep Quality, Covariates And A Possible Intervention, Pranav S. Reddy, Mia Tarditi, Adarsh Gupta, Richard Jermyn, Venkat Venkataraman

Rowan-Virtua Research Day

Sleep is an essential biological process needed to maintain adequate physiologic function. Research has provided growing evidence that chronic failure to get enough sleep is associated with increased risk for obesity, depression, diabetes, hypertension, stroke, cardiovascular disease, and mortality. Sleep deprivation is threatening the health of up to 45% of the world's population. Furthermore, sleep disorders were found to be associated with significantly higher rates of health care utilization and cost, accounting for $94.9 billion in costs each year in the United States. Earlier data from this project demonstrated a correlation between sleep quality and pain. METHODS: Patients were recruited …

Characterizing Multimorbidity Prevalence And Adverse Outcomes In Ethnically And Culturally Diverse Sub-Populations In India: Gaps, Opportunities, And Future Directions, Preeti Zanwar, Robyn Taylor, Tanisha Hill-Jarrett, Elena Tsoy, Jason Flatt, Zunera Mirza, Carl Hill, Arokiasamy Perianayagam

College of Population Health Faculty Papers

India is a large middle-income country and has surpassed China in overall population, comprising 20% of the global population (over 1.43 billion people). India is experiencing a major demographic shift in its aging population. Chronic diseases are common among older adults and can be persistent over the life course, lead to the onset of disability, and be costly. Among older adults in India, the existence of multiple comorbid chronic conditions (i.e., multimorbidity) is rapidly growing and represents a burgeoning public health burden. Prior research identified greater rates of multimorbidity (e.g., overweight/obesity diabetes, hypertension, cardiovascular disease, stroke, and malignancies) in minority …

“It’S Not That We Care Less”: Insights Into Health Care Utilization For Comorbid Diabetes And Depression Among Latinos, Sharon Borja, Miriam G. Valdovinos, Kenia M. Rivera, Natalia Giraldo-Santiago, Robin Gearing, Luis R. Torres-Hostos

School of Social Work Faculty Publications and Presentations

Despite robust knowledge regarding the socio-economic and cultural factors affecting Latino* access to healthcare, limited research has explored service utilization in the context of comorbid conditions like diabetes and depression. This qualitative study, embedded in a larger mixed-methods project, aimed to investigate perceptions held by Latinos and their social support systems (i.e., family members) regarding comorbid diabetes and depression and to identify barriers and facilitators to their help-seeking behaviors and treatment engagement. Bilingual and bicultural researchers conducted eight focus groups with 94 participants in a large U.S. metropolitan area and were primarily conducted in Spanish. The participants either had a …

Hospitalizations For Hepatitis C In Mississippi, 2014-2018 – A Hidden Epidemic, Manuela Staneva Md, Mph, Thomas Dobbs Md, Mph, Paul Byers Md, Meg Pearson Pharmd, Ms, Jonathan Hubanks Pharmd

Journal of Public Health in the Deep South

Goal: Utilizing Mississippi’s hospital discharge data (HDD), we examined trends, demographics, comorbidities, in-hospital deaths, and hospital charges for hospitalizations with diagnoses for hepatitis C virus (HCV).Methods: We conducted a retrospective study of hospitalizations with primary or secondary HCV diagnoses. We performed descriptive and inferential statistical analyses using SAS 9.4. We compared categorical variables with chi-square tests and continuous variables with t-tests.Results: Between 2014 and 2018, patients hospitalized with an HCV diagnosis were more likely to have coexisting intravenous drug use (IDU) diagnoses compared to all other hospitalized patients (20.3% versus 3.3%, p < 0.001). From 2014 to 2018, hepatitis C infections associated with IDU spiked by 53.8%, fueling the overall increase in the number of hepatitis C hospitalizations in Mississippi. Almost one-third (31.8%) of all hepatitis C stays had a severe liver condition and 48.2% had nicotine dependence. The average charges for stays with coexisting HCV and decompensated cirrhosis were $65,975.Conclusions: In Mississippi, there has been a rapid increase in HCV hospitalizations associated with IDU. In addition, HCV hospitalizations were associated with severe morbidity burden and high economic expense. These findings underscore the need for measures aimed at containing the spread of this dangerous but preventable infection.

Mortality From Aspiration Pneumonia: Incidence, Trends, And Risk Factors, Trisha Gupte, John D. Cramer M.D., Arthur Knack Phd, Ccc-Slp

Medical Student Research Symposium

Aspiration pneumonia is a potentially preventable, aggressive type of pneumonia. Little is understood on the burden in mortality from aspiration pneumonia. Our objectives were to first examine the burden of mortality from aspiration pneumonia in the United States and second investigate comorbidities associated with aspiration pneumonia to understand risk factors. We conducted a case-control study of individuals who died of aspiration pneumonia matched to those who died of other causes. We analyzed all deaths in the United States using the Multiple Cause of Death Dataset from 1999-2017. Cases were matched with controls based on age, sex, and race. We calculated …

Comorbidity Burden And Covid-19 Vaccination Intention: Application Of The Health Belief Model, Michael Raymond

Honors Theses

The COVID-19 pandemic impacted many aspects of American’s lives causing over 79 million cases and over 950,000 deaths. Existing research shows severity of COVID-19 infection may be linked to number of underlying health conditions, known as comorbidities. The objective of this study was to determine if comorbidity burden was associated with intention to vaccinate against COVID-19. This relationship was looked at through the Health Belief Model (HBM) and its mediating variables of perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Our sample was compromised of 350 individuals recruited from an online platform who were not already vaccinated against COVID-19. …

Clinical-Epidemiological Profile Of Patients With Covid-19 Treated At A Peruvian Jungle Hospital 2020, Geyner Y. Becerra Uriarte, Hector E. Pardo Lizana, Enrique G. Llontop Ynga, Elmer Lopez-Lopez

Revista de la Facultad de Medicina Humana

Introduction: The epidemic that had its beginning in the city of Wuhan in December 2019, has become a public health problem that is advancing at dizzying steps. Objective: To determine the clinical and epidemiological profile in Covid-19 patients attended at the Hospital Apoyo I Santiago Apóstol - Utcubamba, 2020. Method: The type of research was observational, descriptive and retrospective cross-sectional. The population consisted of 312 patients from which a sample of 173 patients was extracted that met the conditions of being representative and adequate. All data processing and statistical calculations were performed using Microsoft Excel 2019 software. Results: Regarding the …

Decrease Of Cardiovascular Risk In Obese Patients Who Participated In A Lifestyle Medicine Program, Eymard Torres-Rodriguez, Lucy Perla Gulliana Cedillo Ramírez

Revista de la Facultad de Medicina Humana

Lifestyle Medicine in the management of chronic diseases such as obesity is essential to reduce cardiovascular risk and to reverse the disease process (1). Objective: To determine if a Lifestyle Medicine program can reduce cardiovascular risk in obese adults in Colombia. Material and methods: Descriptive observational study cases series type followed for 6 months in a Lifestyle Medicine Clinic. 9 patients were included taking into account 2 measures of cardiovascular risk as a parameter to complete the program. The following measurements were taken: cardiovascular risk using the Pan American Health Organization (PAHO) calculator, Body Mass Index (BMI), lipid profile, history …

Association Between Antiretroviral Therapy And Severe Covid-19 Outcomes Among Hospitalized Hiv Positive People With Sars-Cov-2 In Nys, Aizhan Kyzayeva

Legacy Theses & Dissertations (2009 - 2024)

IMPORTANCE The role of antiretroviral therapy (ART) type in people living with HIV (PLWDH) co-infected with acute respiratory syndrome coronavirus 2 (SARS-Cov-2) remains unclear. There is evidence that certain classes of ART may mute the risk of severe COVID-19 outcomes.

Nutrition Education Intervention For Children In Low Socioeconomic Neighborhoods, Archana Menon, Kasmier Viciosi, Joshua Nsubuga

Rowan-Virtua Research Day

Childhood obesity is a public health epidemic affecting 18.5% of children and adolescents in the United States. Children who are obese are more likely to obese as adults. Obesity leads to a number of comorbidities including chronic conditions like high blood pressure, Type II diabetes, and heart disease. Low socioeconomic status (SES), lack of healthy food access, and urban neighborhoods have been associated with childhood obesity. Additionally, convenience stores and other low-price stores tended to display and promote junk foods by the main entrance, whereas supermarkets and higher-income stores tended to display fruits and vegetables. We want to combat these …

Risk Factors For Mortality From Covid-19 In Hospitalized Patients: A Logistic Regression Model, Irma Luz Yupari, Lucia Bardales Aguirre, Julio Rodriguez Azabache, Jaylin Barros Sevillano, Angela Rodríguez Díaz

Revista de la Facultad de Medicina Humana

Introduction: The population is susceptible to COVID-19 and knowing the most predominant characteristics and comorbidities of those affected is essential to diminish its effects. Objective: This study analyzed the biological, social and clinical risk factors for mortality in hospitalized patients with COVID-19 in the district of Trujillo, Peru. Methods: A descriptive type of study was made, with a quantitative approach and a correlational, retrospective, cross-sectional design. Data was obtained from the Ministry of Health’s database, with a sample of 64 patients from March to May 2020. Results: 85,71% of the total deceased are male, the most predominant occupation is Retired …

Impact Of Benzodiazepines And Polysubstance Status On Repeat Non-Fatal Drug Overdoses, Sarah Mayberry, Sarah Nechuta, Shanthi Krishnaswami

Peer Reviewed Articles

Research has shown that benzodiazepines and mental health disorders can increase the likelihood of repeat overdose, but researcher have not explored this association in Tennessee (TN). We examined benzodiazepines, polysubstance overdose status with/without benzodiazepines, and mental health comorbidities with repeat overdose using statewide data in TN. This study analyzed TN hospital discharge data on nonfatal overdoses for patients ages 18–64 from 2012 to 2016 for 21,066 patients with an initial inpatient visit and 36,244 patients with an initial outpatient visit. The study assessed each patient at one year after initial overdose to determine likelihood of repeat overdose. We used a …

Racial Disparity In The Timely Treatment Of Non-Small Cell Lung Cancer, P Neroda, Mei-Chin Hsieh, Xiao-Cheng Wu, K Cartmell, R Mayo, Jiande Wu, Chindo Hicks, L Zhang

School of Public Health Faculty Publications

No abstract provided.

Hospital Emergency Room Visits For Heavy Menstrual Bleeding, Henry John Mead

Walden Dissertations and Doctoral Studies

Heavy menstrual bleeding (HMB) is a well-recognized health issue among women of reproductive age. The characteristics and demographics of women in the community with HMB who present at the emergency department (ED) are not well described. This research aimed to describe the cohort of women who seek treatment at the ED. The Healthcare Cost and Utilization Project 2016 National Emergency Department Sample was examined. The theory of reasoned action predicts that women who present at the ED are exhibiting health seeking behavior. From 32 million records, the inception cohort identified N = 111,555 cases. Using national estimation weights, this translates …

Multimorbidity, Healthcare Processes, And Mortality Among Tb/Hiv Patients Treated With Antiretroviral Therapy In Uganda, Abel Nkolo

Walden Dissertations and Doctoral Studies

Globally, Uganda is one of the 30 tuberculosis (TB) and human immunodeficiency virus (HIV) high burden countries with high antiretroviral therapy (ART) coverage, yet mortality is still high among TB/HIV patients on ART. The reasons for the high mortality have not been fully explored. The purpose of this study was to determine the association between multimorbidity, age, sex, marital status, phase of TB treatment, timing of initiation for ART, and type of TB and mortality among TB/HIV patients on ART in Uganda. The health outcomes conceptual framework with 3 domains that directly or indirectly affect the outcome domain was used …

The Risk Of Physical Multimorbidity In People With Psychotic Disorders: A Systematic Review And Meta-Analysis, Myanca Rodrigues, Joshua C. Wiener, Saverio Stranges, Bridget L. Ryan, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Background: The occurrence of multiple co-occurring chronic health conditions, known as multimorbidity, is associated with decreases in quality of life for patients and poses unique challenges for healthcare systems. Since people with psychotic disorders have an excess of physical health conditions compared to the general population, they may also be at a higher risk for multimorbidity. We conducted a systematic review and meta-analysis to quantify the prevalence and excess risk of multimorbidity among people with psychotic disorders, relative to those without psychosis.

Methods: We searched the MEDLINE, EMBASE, and PsycINFO databases, and conducted forward and backward citation tracing of included …

Mental Health And Chronic Disease Management: Examining The Association Between Depression And Multiple Sclerosis (Ms) Outcomes, Christina J. Glenn

All ETDs from UAB

The aim of this dissertation is to determine whether depression is associated with clinical (relapses and disability worsening) and MRI outcomes in multiple sclerosis (MS) by conducting a secondary data analysis of the CombiRx clinical trial. Psychiatric comorbidities, including depression are common in people living with MS (PwMS), often underreported, and contribute to reduced quality of life and mortality associated with the disease. Most clinical studies that have examined the relationship between depression, depression medication usage, and MS outcomes have been small, excluded participants with relapsing-remitting subtypes and severe depressive symptoms, and had relatively short study periods—all shortcomings this thesis …

Evaluating The Impact Of Tobacco Retailer Density On Smoking Among Patients With Serious Mental Illness And Diabetes In New York State, Amani Alharthy

Legacy Theses & Dissertations (2009 - 2024)

ABSTRACT

Modeling Substance Use And Mental Disorder Comorbidity Using Latent Variable And Network Approaches, Courtney T. Blondino

Theses and Dissertations

Introduction. Substance use disorder (SUD) is a common condition that affects millions of Americans. Addressing SUD has been complicated by comorbid mental disorders and co-occurring substance use. Consequently, detailing and addressing SUD and comorbid SUD represent an important goal to improve the health of Americans.

Objective. The research goal of this dissertation was to characterize the comorbidity between substance use, including tobacco use, and mental disorder symptoms measured as negative affect and externalizing symptoms in a population-based sample using latent variable and network approaches.

Methods. Waves 1 – 3 from the Population Assessment of Tobacco and Health Study were used. …

The Prevalence Of Multimorbidity Among People With Non-Affective Psychotic Disorders 10-Years After First Diagnosis, Myanca D. Rodrigues

Electronic Thesis and Dissertation Repository

Prior research suggests that people with psychotic disorders have an excess risk of individual chronic conditions, however less is known about their risk of co-occurring multiple chronic health conditions; that is, multimorbidity. The overall objective of this thesis was to examine the association between psychotic disorders and multimorbidity using two complementary studies. First, our systematic review and meta-analysis of fourteen studies found that people with psychotic disorders had an increased risk of 2+ chronic conditions relative to those without psychosis (RR=1.69, 95%CI=1.37,2.08). Second, our retrospective matched cohort study found that people with psychotic disorders treated by an early psychosis intervention …

Comorbidity Factors Influence Covid-19 Mortality Much More Than Age, Steven Gjerstad, Andrea Molle

ESI Working Papers

This paper demonstrates that once we control for comorbidity factors, age has a minor effect on COVID-19 mortality. This has implications for the treatment of current and recovered COVID-19 patients, including health screenings of recovered COVID-19 patients, triage decisions for patients in critical care, and prioritization of vaccinations when one is developed. The coronavirus epidemic in Italy has strained hospital resources, including ICU beds and ventilators for those experiencing acute respiratory failure. Studies of COVID-19 in China [1], Italy [2], and the United States [3] show that fatality rates increase rapidly with age, especially beyond age 60. The same studies …

All-Cause And Cause-Specific Mortality Among Medicaid-Insured Women With Preexisting Type 2 Diabetes Mellitus Diagnosed With Breast Cancer : An Epidemiological Analysis Of Linked New York State Medicaid And Cancer Registry Data, Wayne Rashaan Lawrence

Legacy Theses & Dissertations (2009 - 2024)

Background: The present study investigated the influence preexisting type 2 diabetes mellitus (T2DM) and antidiabetic drugs have on all-cause and cause-specific mortality among Medicaid-insured women diagnosed with breast cancer by menopausal status.

Tracking Multimorbidity Changes In Diverse Racial/Ethnic Populations Over Time: Issues And Considerations, Ana R. Quiñones, Heather G. Allore, Anda Botoseneanu, Jason T. Newsom, Corey L. Nagel, David A. Dorr

OHSU-PSU School of Public Health Faculty Publications and Presentations

Multimorbidity is widely recognized as having adverse effects on health and wellbeing and may threaten the ability of older adults to live independently. Much of what is known about multimorbidity rests on research that has largely focused on one point in time, or from a static perspective. Given that there remains a lack of agreement in the field on how to standardize multimorbidity definitions and measurement, it is not surprising that analyzing and predicting multimorbidity development, progression over time, and its impact are still largely unaddressed. As a result, there are important gaps and challenges to measuring and studying multimorbidity …

Intervention For Cognitive Reserve Enhancement In Delaying The Onset Of Alzheimer's Symptomatic Expression (Increase), A Randomized Controlled Trial: Rationale, Study Design, And Protocol, Daniela C. Moga, Brooke F. Beech, Erin L. Abner, Frederick A. Schmitt, Riham H. El Khouli, Ashley I. Martinez, Lynne Eckmann, Mark Huffmyer, Rosmy George, Gregory A. Jicha

Pharmacy Practice and Science Faculty Publications

BACKGROUND: The course of Alzheimer's disease (AD) includes a 10-20-year preclinical period with progressive accumulation of amyloid β (Aβ) plaques and neurofibrillary tangles in the absence of symptomatic cognitive or functional decline. The duration of this preclinical stage in part depends on the rate of pathologic progression, which is offset by compensatory mechanisms, referred to as cognitive reserve (CR). Comorbid medical conditions, psychosocial stressors, and inappropriate medication use may lower CR, hastening the onset of symptomatic AD. Here, we describe a randomized controlled trial (RCT) designed to test the efficacy of a medication therapy management (MTM) intervention to reduce inappropriate …

Comorbidity Profile Of Head And Neck Cancer Patients With And Without Depression, Michaela Frenzel

Capstone Experience

This population-based retrospective study used SEER-Medicare data from 2002-2010 to assess depression, comorbidity, and substance use in the elderly head and neck cancer population. Out of 3,533 head and neck cancer patients, 10.6% had depression diagnoses two years prior to cancer diagnosis, 8.9% were newly diagnosed with depression within one year after cancer diagnosis, and 44.5% of those with preexisting depression had an additional depression diagnosis within one year following cancer diagnosis. Comorbid conditions (p<0.0001) and substance use (p=0.0017) showed associations with depression prior to cancer diagnosis yet, no significant associations with incidence of depression in this head and neck cancer population. This study affirms the need for continual depression screenings in head and neck cancer patients and suggests the need for increased research into the burden of comorbid conditions and substance use within the head and neck cancer population.

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

Correlation Of Chronic Conditions And Pain Scale With Varying Levels Of Obesity In The Geriatric Population, Shabbir Hossain, Adarsh Gupta D.O.

Rowan-Virtua Research Day

The overall objective of this study was to establish whether obesity’s contribution to pain is stronger than vice versa – the medical debilities in elderly patients that contribute to obesity. In the process, this study will allow us to achieve whether different age samples with similar BMIs demonstrate the same level of medical complexities in geriatric patients. In summary, the purpose of this research study was to correlate a relationship between obesity and aging. We hypothesized that obesity will contribute to greater pain in the aging population, and that patients – regardless of their age groups in the aging population …

Pre-Operative Clinical Variation By Health Insurance Carrier In 12,285 Male Surgical Patients With Moderate Morbid Obesity, Matthew E. Moore D.O., Gus J. Slotman M.D.

Rowan-Virtua Research Day

In the ongoing obesity epidemic, every surgeon now treats patients with weight-related medical problems. In managing these medically fragile surgical patients, every clinical insight helps. While variation according to health insurance has been reported in mixed sex bariatric surgery populations, whether or not clinical characteristics in the subset of moderately obese male surgical patients vary by insurance carrier is unknown. The objective of this study was to identify clinical variation by insurance type in moderately obese men.

Results showed that pre-operative clinical characteristics of moderately obese male surgical patients vary by the health insurance coverage type to which they subscribe. …

Depression Among Epileptic Patients And Its Association With Drug Therapy In Sub-Saharan Africa: A Systematic Review And Meta-Analysis., Getenet Dessie, Henok Mulugeta, Cheru Tesema Leshargie, Fasil Wagnew, Sahai Burrowes

BACKGROUND: Despite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. The objective of this systematic review and meta-analysis is to address this gap in the literature by determining the pooled prevalence of depression among epileptic patients in sub-Saharan Africa.

METHODS: A systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization's Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) conducted from December 2, 2017 …