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أمراض الأطفال المزمنة, Suad Fahad Alferaih

Dr. Suad Fahad AlFuraih

No abstract provided.

Awareness, Acceptability And Uptake Of Human Papilloma Virus Vaccine Among Cameroonian School-Attending Female Adolescents, Claudine Ayissi, Richard Wamai, Geofrey Oduwo, Stacey Perlman, Edith Welty, Simon Manga, Javier Ogembo

Richard G. Wamai

The purpose of this study is to assess awareness, knowledge and beliefs about HPV, cervical cancer HPV vaccine and willingness to vaccinate among adolescent females aged 12-26 years at clinics and schools in the North West Region of Cameroon where the Cameroon Baptist Convention Health Services (CBCHS) conducted a sensitization and education campaign. A questionnaire survey was administered among female adolescents in schools and clinics. Descriptive statistics including frequencies, percentages and proportions were generated for independent variables and bivariate analyses (Chi square test) were used to assess the relationship between independent and outcome variables. Data were analyzed using SAS Version …

Recent Trends In Post-Discharge Mortality Among Patients With An Initial Acute Myocardial Infarction, Andrew Coles, Kimberly Fisher, Chad Darling, David Mcmanus, Oscar Maitas, Jorge Yarzebski, Joel Gore, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

The objectives of this study were to describe contemporary postdischarge death rates of patients hospitalized at all Worcester, Massachusetts, hospitals after initial acute myocardial infarctions (AMIs) and to examine factors associated with a poor prognosis. The medical records of patients discharged from 11 central Massachusetts medical centers after initial AMIs during 2001, 2003, 2005, and 2007 were reviewed, identifying 2,452 patients. This population was composed of predominantly older patients, men (58%), and whites. Overall, the 3-month, 1-year, and 2-year all-cause death rates were 8.9%, 16.4%, and 23.4%, respectively. Over time, reductions in postdischarge mortality were observed in crude as well …

Factors Associated With Inadequate Colorectal Cancer Screening With Flexible Sigmoidoscopy, Adeyinka Laiyemo, Chyke Doubeni, Paul Pinsky, V. Paul Doria-Rose, Andrew Sanderson, Robert Bresalier, Joel Weissfeld, Robert Schoen, Pamela Marcus, Phillip Prorok, Christine Berg

Chyke A. Doubeni

BACKGROUND AND STUDY AIM: Inadequate colorectal cancer screening wastes limited endoscopic resources. We examined patients factors associated with inadequate flexible sigmoidoscopy (FSG) screening at baseline screening and repeat screening 3-5 years later in 10 geographically-dispersed screening centers participating in the ongoing Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

METHODS: A total of 64,554 participants (aged 55-74) completed baseline questionnaires and underwent FSG at baseline. Of these, 39,385 participants returned for repeat screening. We used logistic regression models to assess factors that are associated with inadequate FSG (defined as a study in which the depth of insertion of FSG was …

Contribution Of Behavioral Risk Factors And Obesity To Socioeconomic Differences In Colorectal Cancer Incidence, Chyke Doubeni, Jacqueline Major, Adeyinka Laiyemo, Mario Schootman, Ann Zauber, Albert Hollenbeck, Rashmi Sinha, Jeroan Allison

Chyke A. Doubeni

BACKGROUND:Health behaviors are known risk factors for colorectal cancer and are more common in low socioeconomic status (SES) populations. We evaluated the extent to which behavioral risk factors and body mass index (BMI) explain SES disparities in colorectal cancer incidence, overall and by tumor location.

METHODS: We analyzed prospective National Institutes of Health-AARP Diet and Health Study data on 506 488 participants who were recruited in 1995-1996 from six US states and two metropolitan areas and followed through 2006. Detailed baseline data on risk factors for colorectal cancer, including health behaviors, were obtained using questionnaires. SES was measured by self-reported …

Socioeconomic Status, Healthcare Density, And Risk Of Prostate Cancer Among African American And Caucasian Men In A Large Prospective Study, Jacqueline Major, M. Oliver, Chyke Doubeni, Albert Hollenbeck, Barry Graubard, Rashmi Sinha

Chyke A. Doubeni

OBJECTIVES: The purpose of this study was to separately examine the impact of neighborhood socioeconomic deprivation and availability of healthcare resources on prostate cancer risk among African American and Caucasian men. METHODS: In the large, prospective NIH-AARP Diet and Health Study, we analyzed baseline (1995-1996) data from adult men, aged 50-71 years. Incident prostate cancer cases (n = 22,523; 1,089 among African Americans) were identified through December 2006. Lifestyle and health risk information was ascertained by questionnaires administered at baseline. Area-level socioeconomic indicators were ascertained by linkage to the US Census and the Area Resource File. Multilevel Cox models were …

Variation Of Adenoma Prevalence By Age, Sex, Race, And Colon Location In A Large Population: Implications For Screening And Quality Programs, Douglas Corley, Christopher Jensen, Amy Marks, Wei Zhao, Jolanda De Boer, Theodore Levin, Chyke Doubeni, Bruce Fireman, Charles Quesenberry

Chyke A. Doubeni

BACKGROUND and AIMS: Reliable community-based colorectal adenoma prevalence estimates are needed to inform colonoscopy quality standards and to estimate patient colorectal cancer risks; however, minimal data exist from populations with large numbers of diverse patients and examiners. METHODS: We evaluated the prevalence of adenomas detected by sex, age, race/ethnicity, and colon location among 20,792 Kaiser Permanente Northern California members >/=50 years of age who received a screening colonoscopy exam (102 gastroenterologists, years 2006-2008). RESULTS: Prevalence of detected adenomas increased more rapidly with age in the proximal colon (adjusted odds ratio [OR], 2.39; 95% confidence interval [CI], 2.05-2.80; 70-74 vs 50-54 …

Self-Reported Colorectal Cancer Screening Of Medicare Beneficiaries In Family Medicine Vs. Internal Medicine Practices In The United States: A Cross-Sectional Study, Angela (Young) Higgins, Anna R. B. Doubeni, Karon L. Phillips, Adeyinka O. Laiyemo, Becky A. Briesacher, Jennifer Tjia, Chyke A. Doubeni

Jennifer Tjia

BACKGROUND: The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians.

METHODS: Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main …

Self-Reported Colorectal Cancer Screening Of Medicare Beneficiaries In Family Medicine Vs. Internal Medicine Practices In The United States: A Cross-Sectional Study, Angela Higgins, Anna Doubeni, Karon Phillips, Adeyinka Laiyemo, Becky Briesacher, Jennifer Tjia, Chyke Doubeni

Chyke A. Doubeni

BACKGROUND: The benefit of screening for decreasing the risk of death from colorectal cancer (CRC) has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs) vs. internal medicine (internists) physicians. METHODS: Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey). The main …

Assessing The Effectiveness Of A Community-Based Sensitization Strategy In Creating Awareness About Hpv, Cervical Cancer And Hpv Vaccine Among Parents In North West Cameroon, Richard Wamai, Claudine Ayissi, Geofrey Oduwo, Stacey Perlman, Edith Welty, Simon Manga, Javier Ogembo

Richard G. Wamai

In 2010, the Cameroon Baptist Convention Health Services (CBCHS) received a donation of HPV vaccine (Gardasil(A (R))) to immunize girls of ages 9-13 years in the North West Region of Cameroon. We evaluated the effectiveness of the CBCHS campaign program in sensitizing parents/guardians to encourage HPV vaccine uptake, identified factors that influence parents' decisions to vaccinate girls, and examined the uptake of cervical cancer screening among mothers. We conducted a cross-sectional survey in four healthcare facilities run by CBCHS, churches and other social settings. A total of 350 questionnaires were distributed and 317 were used for the analysis. There were …

The Plan Score, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Thirty-Year (1975 To 2005) Trends In The Incidence Rates, Clinical Features, Treatment Practices, And Short-Term Outcomes Of Patients [Less Than] 55 Years Of Age Hospitalized With An Initial Acute Myocardial Infarction, David Mcmanus, Stephen Piacentine, Darleen Lessard, Joel Gore, Jorge Yarzebski, Frederick Spencer, Robert Goldberg

Jorge L. Yarzebski

Sparse data are available describing recent trends in the magnitude, clinical features, treatment practices, and outcomes of comparatively young adults hospitalized with acute myocardial infarction (AMI). The objectives of this population-based study were to describe 3 decade-long trends (1975 to 2005) in these end points in adults 1,703 residents of the Worcester (Massachusetts) metropolitan area 25 to 54 years of age who were hospitalized with initial AMIs at all central Massachusetts medical centers during 15 annual periods from 1975 through 2005. Overall hospital incidence rate (per 100,000 residents) of initial AMI in our study population was 66 (95% confidence interval …

Six-Month Mortality And Cardiac Catheterization In Non-St-Segment Elevation Myocardial Infarction Patients With Anemia, Wen-Chih Wu, Molly Waring, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: It is unknown how anemia influences the invasive management of patients with non-ST-segment elevation myocardial infarction (NSTEMI) and associated mortality. We investigated whether receipt of cardiac catheterization relates to 6-month death rates among patients with different severity of anemia. METHODS: We used data from the population-based Worcester Heart Attack Study, which included 2634 patients hospitalized with confirmed NSTEMI, from three percutaneous coronary intervention-capable medical centers in the Worcester (Massachusetts, U.S.A.) metropolitan area, during five biennial periods between 1997 and 2005. Severity of anemia was categorized using admission hematocrit levels: less than or equal to 30.0% (moderate-to-severe anemia), 30.1-39.0% (mild …

Immunizations For Adults And Children, Lynne J. Goebel, Nancy B. Norton, Maurice A. Mufson

Maurice A. Mufson

Vaccines represent the most important medical advance of the twentieth century. The time has passed when large numbers of children and adults suffered serious, life threatening illness from viruses including poliovirus, measles virus, influenza viruses, hepatitis B virus and varicella zoster virus or faced lifelong disability or death from bacterial infections including Hemophilus influenzae, meningococcus and pneumococcus, all infections that can be prevented now by effective vaccines.

Immunizations For Adults And Children, Lynne J. Goebel, Nancy B. Norton, Maurice A. Mufson

Nancy B. Norton

Vaccines represent the most important medical advance of the twentieth century. The time has passed when large numbers of children and adults suffered serious, life threatening illness from viruses including poliovirus, measles virus, influenza viruses, hepatitis B virus and varicella zoster virus or faced lifelong disability or death from bacterial infections including Hemophilus influenzae, meningococcus and pneumococcus, all infections that can be prevented now by effective vaccines.

Immunizations For Adults And Children, Lynne J. Goebel, Nancy B. Norton, Maurice A. Mufson

Lynne J. Goebel

Vaccines represent the most important medical advance of the twentieth century. The time has passed when large numbers of children and adults suffered serious, life threatening illness from viruses including poliovirus, measles virus, influenza viruses, hepatitis B virus and varicella zoster virus or faced lifelong disability or death from bacterial infections including Hemophilus influenzae, meningococcus and pneumococcus, all infections that can be prevented now by effective vaccines.

Criticisms Of African Trials Fail To Withstand Scrutiny: Male Circumcision Does Prevent Hiv Infection, Richard Wamai, Brian Morris, Jake Waskett, Edward Green, Joya Banerjee, Robert Bailey, Jeffrey Klausner, David Sokal, Catherine Hankins

Richard G. Wamai

A recent article in the JLM (Boyle GJ and Hill G, "Sub-Saharan African Randomised Clinical Trials into Male Circumcision and HIV Transmission: Methodological, Ethical and Legal Concerns" (2011) 19 JLM 316) criticises the large randomised controlled trials (RCTs) that scientists, clinicians and policy-makers worldwide have concluded provide compelling evidence in support of voluntary medical male circumcision (VMMC) as an effective HIV prevention strategy. The present article addresses the claims advanced by Boyle and Hill, demonstrating their reliance on outmoded evidence, outlier studies, and flawed statistical analyses. In the current authors' view, their claims portray misunderstandings of the design, execution and …

Residential Traffic Exposure, Pulse Pressure, And C-Reactive Protein: Consistency And Contrast Among Exposure Characterization Methods, Christine L. Rioux, Katherine L. Tucker, Mkaya Mwamburi, David M. Gute, Steven A. Cohen, Doug Brugge

Katherine L. Tucker

Background: Traffic exposure may increase cardiovascular disease (CVD) risk via systemic inflammation and elevated blood pressure, two important clinical markers for managing disease progression. Objectives: We assessed degree and consistency of association between traffic exposure indicators as predictors of C-reactive protein (CRP) and pulse pressure (PP) in an adult U.S. Puerto Rican population (n = 1,017). Methods: Cross-sectional information on health and demographics and blood data was collected. Using multiple linear regression, we tested for associations between CRP, PP, and six traffic exposure indicators including residential proximity to roads with > 20,000 vehicles/day and traffic density [vehicle miles traveled per square …

Common Roots: A Contextual Review Of Hiv Epidemics In Black Men Who Have Sex With Men Across The African Diaspora, Gregorio A. Millett, William L. Jeffries 4h, John L. Peterson, David J. Malebranche, Tim Lane, Stephen A. Flores, Kevin A. Fenton, Patrick A. Wilson, Riley Steiner, Charles M. Heilig

David J Malebranche

Pooled estimates from across the African diaspora show that black men who have sex with men (MSM) are 15 times more likely to be HIV positive compared with general populations and 8·5 times more likely compared with black populations. Disparities in the prevalence of HIV infection are greater in African and Caribbean countries that criminalise homosexual activity than in those that do not criminalise such behaviour. With the exception of US and African epidemiological studies, most studies of black MSM mainly focus on outcomes associated with HIV behavioural risk rather than on prevalence, incidence, or undiagnosed infection. Nevertheless, black MSM …

Intracerebral Hemorrhage In Cerebral Venous Thrombosis, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Assessing Patient-Provider Collaboration In Subjects With Type 2 Diabetes In Jamaica And Effects On Glycemic Control, Paul E. Daniel Jr., Michael A. Godkin, Judith A. Savageau, Rosemarie Wright-Pascoe, Michael G. Lee

Judith A. Savageau

Background: Type 2 Diabetes Mellitus is a growing health problem worldwide that places patients at increased risk of morbidity and mortality from microvascular and macrovascular complications. Research suggests that a patient-centered approach which focuses on patient-physician communication and collaboration in the management of chronic diseases such as diabetes may improve clinical outcomes in a glycemic parameter such as HbA1c. We measured the degree of this patient-centered approach in a sample population of subjects with Type 2 Diabetes in Jamaica with the use of the Patient Assessment of Care for Chronic Illness (PACIC) questionnaire and assessed the relationship between patient-centered care …

Biological Basis For The Protective Effect Conferred By Male Circumcision Against Hiv Infection, Brian Morris, Richard Wamai

Richard G. Wamai

Here we provide an up-to-date review of research that explains why uncircumcised men are at higher risk of HIV infection. The inner foreskin is a mucosal epithelium deficient in protective keratin, yet rich in HIV target cells. Soon after sexual exposure to infected mucosal secretions of a HIV-positive partner, infected T-cells from the latter form viral synapses with keratinocytes and transfer HIV to Langerhans cells via dendrites that extend to just under the surface of the inner foreskin. The Langerhans cells with internalized HIV migrate to the basal epidermis and then pass HIV on to T-cells, thus leading to the …

Mama What Is Celiac, Suad Fahad Alferaih

Dr. Suad Fahad AlFuraih

قصة ماما ماهو السلياك

A Systematic Review Of Validated Methods For Identifying Heart Failure Using Administrative Data, Jane Saczynski, Susan Andrade, Leslie Harrold, Jennifer Tjia, Sarah Cutrona, Katherine Dodd, Robert Goldberg, Jerry Gurwitz

Jennifer Tjia

PURPOSE: To identify and describe the validity of algorithms used to detect heart failure (HF) using administrative and claims data sources.

METHODS: A systematic review of PubMed and Iowa Drug Information Service searches of the English language was performed to identify studies published between 1990 and 2010 that evaluated the validity of algorithms for the identification of patients with HF using and claims data. Abstracts and articles were reviewed by two study investigators to determine their relevance on the basis of predetermined criteria.

RESULTS: The initial search strategy identified 887 abstracts. Of these, 499 full articles were reviewed and 35 …

A Systematic Review Of Validated Methods For Identifying Cerebrovascular Accident Or Transient Ischemic Attack Using Administrative Data, Susan Andrade, Leslie Harrold, Jennifer Tjia, Sarah Cutrona, Jane Saczynski, Katherine Dodd, Robert Goldberg, Jerry Gurwitz

Jennifer Tjia

PURPOSE: To perform a systematic review of the validity of algorithms for identifying cerebrovascular accidents (CVAs) or transient ischemic attacks (TIAs) using administrative and claims data. METHODS: PubMed and Iowa Drug Information Service searches of the English language literature were performed to identify studies published between 1990 and 2010 that evaluated the validity of algorithms for identifying CVAs (ischemic and hemorrhagic strokes, intracranial hemorrhage, and subarachnoid hemorrhage) and/or TIAs in administrative data. Two study investigators independently reviewed the abstracts and articles to determine relevant studies according to pre-specified criteria. RESULTS: A total of 35 articles met the criteria for evaluation. …

Kenya Keen On Achieving Targets On Neglected Diseases, Richard Wamai

Richard G. Wamai

No abstract provided.

Socioeconomic Status And The Risk Of Colorectal Cancer: An Analysis Of More Than A Half Million Adults In The National Institutes Of Health-Aarp Diet And Health Study, Chyke Doubeni, Adeyinka Laiyemo, Jacqueline Major, Mario Schootman, Min Lian, Yikyung Park, Barry Graubard, Albert Hollenbeck, Rashmi Sinha

Chyke A. Doubeni

BACKGROUND: No previous prospective US study has examined whether the incidence of colorectal cancer (CRC) is disproportionately high in low socioeconomic status (SES) populations of both men and women. This study examined the relationship between both individual and area-level SES and CRC incidence, overall and by tumor location. METHODS: Data were obtained from the ongoing prospective National Institutes of Health-AARP Diet and Health Study of persons (50-71 years old) who resided in 6 US states and 2 metropolitan areas at baseline in 1995-1996. Incident CRCs were ascertained from tumor registries through December 2006. SES was measured by self-reported education and …

Treatment Practices And Outcomes Of Patients With Established Peripheral Arterial Disease Hospitalized With Acute Myocardial Infarction In A Community Setting, Frederick Spencer, Darleen Lessard, Chyke Doubeni, Jorge Yarzebski, Joel Gore, Robert Goldberg

Chyke A. Doubeni

BACKGROUND: There are little contemporary data available describing the hospital and long-term outcomes of patients with peripheral arterial disease (PAD) who are hospitalized with acute myocardial infarction (AMI). The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI. METHODS: The study sample consisted of 4480 patients hospitalized with AMI at all Worcester, Mass, medical centers in 4 alternate years between 1997 and 2003. RESULTS: Among the metropolitan Worcester residents hospitalized with AMI, 13.5% had a history of …

The Susceptibility Of Trypanosomatid Pathogens To Pi3/Mtor Kinase Inhibitors Affords A New Opportunity For Drug Repurposing, Rosario Diaz-Gonzalez, F. Kuhlmann, Cristina Galan-Rodriguez, Luciana Madeira Da Silva, Caitlin Karver, Ana Rodriguez, Stephen Beverley, Miguel Navarro, Michael Pollastri

Michael Pollastri

Background Target repurposing utilizes knowledge of "druggable" targets obtained in one organism and exploits this information to pursue new potential drug targets in other organisms. Here we describe such studies to evaluate whether inhibitors targeting the kinase domain of the mammalian Target of Rapamycin (mTOR) and human phosphoinositide-3-kinases (PI3Ks) show promise against the kinetoplastid parasites Trypanosoma brucei, T. cruzi, Leishmania major, and L. donovani. The genomes of trypanosomatids encode at least 12 proteins belonging to the PI3K protein superfamily, some of which are unique to parasites. Moreover, the shared PI3Ks differ greatly in sequence from those of the human host, …

A 25-Year Perspective Into The Changing Landscape Of Patients Hospitalized With Acute Myocardial Infarction (The Worcester Heart Attack Study), Robert Goldberg, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore, Joseph Alpert, James Dalen

Jorge L. Yarzebski

Over the past several decades, significant advances have been made in the primary and secondary prevention of coronary artery disease. However, effects of changing lifestyle and treatment practices on demographic and clinical profiles and on hospital outcomes of patients who present with acute myocardial infarction (AMI) have not been well characterized. We carried out a prospective population-based investigation of >25-year trends (1975 to 2001) in demographic and clinical characteristics, treatment practices, and hospital outcomes of patients who had been hospitalized with AMI. Residents of a metropolitan area (Worcester, Massachusetts) who had been hospitalized with validated AMI (n = 10,440) in …