Epidemiology Commons^™

Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes …

Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Time to clinical stability is a well-defined early clinical outcome in hospitalized patients with community-acquired pneumonia, but it has not been evaluated in patients with ventilator-associated pneumonia (VAP). The objective of this study was to compare time to clinical stability in patients with MRSA VAP treated with linezolid versus vancomycin.

Methods: This was a secondary analysis of the IMPACT-HAP study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. A patient was considered to reach clinical stability the day that the following four criteria were …

A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin

The University of Louisville Journal of Respiratory Infections

Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority of including …

Global Stability Of Nonlinear Stochastic Sei Epidemic Model With Fluctuations In Transmission Rate Of Disease, Olusegun Michael Otunuga

Mathematics Faculty Research

We derive and analyze the dynamic of a stochastic SEI epidemic model for disease spread. Fluctuations in the transmission rate of the disease bring about stochasticity in model. We discuss the asymptotic stability of the infection-free equilibrium by first deriving the closed form deterministic (R₀) and stochastic (R₀) basic reproductive number. Contrary to some author’s remark that different diffusion rates have no effect on the stability of the disease-free equilibrium, we showed that even if no epidemic invasion occurs with respect to the deterministic version of the SEI model (i.e., R₀ < 1), epidemic can still grow initially (if R₀ > 1) …

Association Of Body Mass Index With Dna Methylation And Gene Expression In Blood Cells And Relations To Cardiometabolic Disease: A Mendelian Randomization Approach, Michael M. Mendelson, Riccardo E. Marioni, Roby Joehanes, Chunyu Liu, Åsa K. Hedman, Stella Aslibekyan, Ellen W. Demerath, Weihua Guan, Degui Zhi, Chen Yao, Tianxiao Huan, Christine Willinger, Brian Chen, Paul Courchesne, Michael Multhaup, Marguerite R. Irvin, Ariella Cohain, Eric E. Schadt, Megan L. Grove, Jan Bressler, Kari North, Johan Sundström, Stefan Gustafsson, Sonia Shah, Allan F. Mcrae, Sarah E. Harris, Jude Gibson, Paul Redmond, Janie Corley, Lee Murphy, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background

The link between DNA methylation, obesity, and adiposity-related diseases in the general population remains uncertain.

Methods and Findings

We conducted an association study of body mass index (BMI) and differential methylation for over 400,000 CpGs assayed by microarray in whole-blood-derived DNA from 3,743 participants in the Framingham Heart Study and the Lothian Birth Cohorts, with independent replication in three external cohorts of 4,055 participants. We examined variations in whole blood gene expression and conducted Mendelian randomization analyses to investigate the functional and clinical relevance of the findings. We identified novel and previously reported BMI-related differential methylation at 83 CpGs …

Recurrent Pneumonia Among Japanese Adults: Disease Burden And Risk Factors, Tomoko Ishifuji, Eiichiro Sando, Norihiro Kaneko, Motoi Suzuki, Paul E. Kilgore, Koya Ariyoshi, Konosuke Morimoto, Naoto Hosokawa, Makito Yaegashi, Masahiro Aoshima, Adult Pneumonia Study Group - Japan (Apsg-J)

Department of Pharmacy Practice

Background: In Japan and other societies with rapidly aging populations, recurrent pneumonia (RP) is a major clinical problem yet only limited information exists regarding the burden of this disease.

Methods: A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk factors. From February 1, 2012 to January 31, 2013, patients aged ≥ 15 years who were diagnosed with pneumonia were prospectively enrolled in a representative community hospital located in central Japan. Patients were followed for one-year to evaluate the recurrence of pneumonia and characteristics associated with RP. Cox proportional hazards models were constructed …

Breast Cancer Care In California And Ontario: Primary Care Protections Greatest Among The Most Socioeconomically Vulnerable Women Living In The Most Underserved Places, Kevin M. Gorey, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty

Social Work Publications

Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation …

Exploring Sexual And Behavioral Health Inequities Among College Students: A Need For Lgb-Specific Risk Reduction, Todd M. Sabato

Journal of Health Disparities Research and Practice

Many studies have examined differences in sexual behavior based upon self-identified sexual orientation, with results often indicating that those with same-sex partners engage in greater risk behaviors than those with opposite sex partners. However, few of those studies consisted of large, national sample studies. To address that gap, the present study examined the relationship between sexual orientation and both behavioral and sexual health outcomes in a national sample of U.S. college students. The Fall 2012 through Spring 2014 American College Health Association National College Health Assessment was used to examine behavioral and sexual health related responses from self-identified heterosexual, gay, …

Overcoming Recruitment Challenges: A Pilot Study In Arab Americans, Nawar M. Shara, Sayf A. Yassin, Soleman H. Abu-Bader, Asqual Getaneh, Shaunagh Browning, Alexander Zeymo, Barbara V. Howard, Zeid Abudiab, Anas Shahrour, Jason G. Umans

Journal of Health Disparities Research and Practice

While diabetes prevalence and cardiovascular risk factors have been increasing among Arab populations worldwide, few studies of Arab Americans have been conducted because of the difficulty in recruiting Arab American participants. Cultural sensitivity and social awareness of different immigrant groups could ensure successful recruitment and retention in clinical studies. While the primary objective of our overall research project was to determine the prevalence of metabolic syndrome in Arab Americans, the focus of this article is to describe the methodology used to overcome challenges in recruiting and enrolling Arab Americans for a community-based study. We used novel methods, including open houses, …

Research Methods In Occupational Health Psychology, Irvin Sam Schonfeld, Chu-Hsiang Chang

Publications and Research

http://www.springerpub.com/occupational-health-psychology.html

Occupational Health Psychology (OHP) is a rapidly expanding interdisciplinary field that focuses on the science and practice of psychology in promoting and developing workplace health- and safety-related initiatives. This comprehensive text for undergraduate and graduate survey courses is the first to encompass a wide range of key issues in OHP. It draws from the domains of psychology, public health, preventive medicine,nursing, industrial engineering, law, and epidemiology to focus on the theory and practice of protecting and promoting the health, well-being, and safety of individuals in the workplace and improving the quality of work life.

The text addresses key psychosocial …

The Cardiovascular Epidemiology And Genome-Wide Associations Of Biomarkers Of Innate And Adaptive Immunity: Scd163 And Sil2ra, Jon Peter Durda

Graduate College Dissertations and Theses

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in the U.S. and worldwide. Atherosclerosis, the buildup of plaque in the arteries, is a common cause of CVD. For many years, research in atherosclerosis was focused on lipid metabolism and the accumulation of low-density lipoprotein in the arteries. While this research set public health guidelines for lipid management, lipid concentration was not the only factor influencing atherosclerosis and CVD events. Many scientists, as far back as the 1850’s recognized the role of inflammation in the progression of atherosclerotic disease. The continuous low levels of immune activation in the …

Predictors Of Mastectomy In Male Breast Cancer, Esther Opara

Walden Dissertations and Doctoral Studies

Male breast cancer (MBC) is rare, and research on the predictors of MBC has been limited because of inadequate funding in and outside of the United States. One goal of this study was to eradicate the stereotyping of breast cancer as a female disease. The emergence of medical technology and education to benefit the public will help to ensure greater health awareness at the individual, community, and global levels. The purpose of this study was to understand the influence of the predictors of age; race (Black, White, and Other); and grade of cancer (I, II, or III) on the outcome …

Visualizing The Diffusion Of Digital Mammography In New York State, Francis P. Boscoe, Xiuling Zhang

Epidemiology & Biostatistics Faculty Scholarship

Digital mammography saw rapid adoption during the first decade of the 2000s. According to data maintained by the Food and Drug Administration, which regulates mammography machines, fewer than 1 percent of the machines in 2001 were digital. By 2014, this figure had risen to 94%. We were interested in identifying the times and locations where the technology was introduced within the state of New York as a way of illustrating the uneven introduction of this technology. While the diffusion of medical innovation has been well-studied, there have not been many instances where maps or geographic information science methods have been …

Early Diagnosis And Intervention For Young Children With Autism Spectrum Disorder In New York State, Grace Ester Caroline Korompis

Health Policy, Management & Behavior Theses & Dissertations

This study examined the prevalence of autism spectrum disorder (ASD), analyzed the trends, assessed children’s sociodemographic characteristics and examined timing of ASD diagnosis among children who enrolled in the New York State Early Intervention Program (NYSEIP).

Secondary data from the New York State Early Intervention data systems were used. The systems include NYEIS (New York State Early Intervention System), a centralized web-based system that electronically manages the NYSEIP administrative tasks and was designed to support the NYSEIP's services, and the legacy data system: KIDS (Kids Integrated Data System). The time-trend design employed in this study was a form of longitudinal …

A New Evolutionary Algorithm For Mining Noisy, Epistatic, Geospatial Survey Data Associated With Chagas Disease, John P. Hanley

Graduate College Dissertations and Theses

The scientific community is just beginning to understand some of the profound affects that feature interactions and heterogeneity have on natural systems. Despite the belief that these nonlinear and heterogeneous interactions exist across numerous real-world systems (e.g., from the development of personalized drug therapies to market predictions of consumer behaviors), the tools for analysis have not kept pace. This research was motivated by the desire to mine data from large socioeconomic surveys aimed at identifying the drivers of household infestation by a Triatomine insect that transmits the life-threatening Chagas disease. To decrease the risk of transmission, our colleagues at the …

Anti-Müllerian Hormone And Its Relationships With Subclinical Cardiovascular Disease And Renal Disease In A Longitudinal Cohort Study Of Women With Type 1 Diabetes, Catherine Kim, Yuanyuan Pan, Barbara Braffett, Valerie Arends, Michael Steffes, Hunter Wessells, Aruna V. Sarma

GW Biostatistics Center

Background

Reproductive age may be a risk factor for vascular disease. Anti-Müllerian hormone (AMH) is produced by viable ovarian follicles and reflects reproductive age. We examined whether AMH concentrations were associated with markers of subclinical cardiovascular disease (CVD) and kidney disease among women with type 1 diabetes.

Methods

We performed a cross-sectional analysis of the Epidemiology of Diabetes Interventions and Complications Study. Participants included women with type 1 diabetes and ≥1 AMH measurement (n = 390). In multivariable regression models which adjusted for repeated measures, we examined the associations between AMH with CVD risk factors, estimated glomerular filtration rate, …

Detecting Discordance Enrichment Among A Series Of Two-Sample Genome-Wide Expression Data Sets, Yinglei Lai, Fanni Zhang, Tapan Nayak, Reza Modarres, Norman H. Lee, Timothy A. Mccaffrey

Epidemiology Faculty Publications

Background

With the current microarray and RNA-seq technologies, two-sample genome-wide expression data have been widely collected in biological and medical studies. The related differential expression analysis and gene set enrichment analysis have been frequently conducted. Integrative analysis can be conducted when multiple data sets are available. In practice, discordant molecular behaviors among a series of data sets can be of biological and clinical interest.

Methods

In this study, a statistical method is proposed for detecting discordance gene set enrichment. Our method is based on a two-level multivariate normal mixture model. It is statistically efficient with linearly increased parameter space when …

Post-Diagnosis Body Mass Index And Mortality Among Women Diagnosed With Endometrial Cancer: Results From The Women's Health Initiative., Hannah Arem, Ruth M Pfeiffer, Steven C Moore, Melinda L Irwin, Michael J Lamonte, Gloria E Sarto, Rami Nassir, Juhua Luo, Rowan T Chlebowski, Louise A Brinton, Charles E Matthews

Epidemiology Faculty Publications

Higher body mass index (BMI) measured before endometrial cancer diagnosis has been associated with greater risk of developing endometrial cancer and higher mortality, but the association between BMI measured after diagnosis and mortality risk is unclear. We identified 467 women (91 deaths) in the Women's Health Initiative (WHI) with information on BMI measured after diagnosis and used Cox proportional hazards regression to generate hazard ratios (HR) and 95% confidence intervals (CI) for all-cause mortality. Comparing BMI 35+ with/m2, we observed no association with all-cause mortality (HR = 1.02, 95% CI 0.55-1.91). Our study does not support the hypothesis that higher …

Conventional Early Infant Diagnosis In Lesotho From Specimen Collection To Results Usage To Manage Patients: Where Are The Bottlenecks?, Appolinaire Tiam, Michelle M Gill, Heather J Hoffman, Anthony Isavwa, Mafusi Mokone, Matokelo Foso, Jeffrey T Safrit, Lynne M Mofenson, Thorkild Tylleskär, Laura Guay

Epidemiology Faculty Publications

INTRODUCTION: Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade.

METHODS: We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means …

Assessing Very Early Infant Diagnosis Turnaround Times: Findings From A Birth Testing Pilot In Lesotho, Michelle Gill, Heather J. Hoffman, Majoalane Mokone, Vincent Tukei, Matsepeli Nchephe, +Several Additional Authors

Epidemiology Faculty Publications

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants’ HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result …