Medicine and Health Sciences Commons^™

Chest Computed Tomography And Magnetic Resonance Imaging Texture Measurements Of Chronic Obstructive Pulmonary Disease, Maksym Sharma

Electronic Thesis and Dissertation Repository

Pulmonary imaging using computed tomography (CT) and magnetic resonance imaging (MRI) provide a method to measure airway and parenchymal pathologic information that cannot be provided using spirometry. Currently, it remains difficult to predict which chronic obstructive pulmonary disease (COPD) patients will worsen using spirometry, which although safe and inexpensive, does not provide small airway information where COPD is believed to initiate. Quantitative CT and MRI measurements provide regional structure and function information but are not included in mortality risk assessments, prognosis, or COPD staging. Therefore, my overarching hypothesis is that CT and MRI ventilation texture measurements combined with machine learning …

Association Of Socioeconomic, Racial, And Regional Factors With In-Hospital Management And Outcomes Of Acute Myocardial Infarction Patients In The United States: National Analyses Of 2.8 Million Admissions, Olivia Haldenby

Electronic Thesis and Dissertation Repository

Social determinants of health contribute to variations in clinical outcomes among acute myocardial infarction (AMI) patients. Using the National Inpatient Sample, we conducted retrospective cohort analyses to evaluate the association of income, race, and geography with in-hospital mortality and revascularization procedures among AMI admissions in the United States from 2015 to 2019. Multilevel logistic regression models were used while accounting for hospital clustering and relevant predictors. A sequential model-building approach produced model 1 (unadjusted patient-level exposures), model 2 (lifestyle factors), model 3 (clinical characteristics), and model 4 (fully adjusted hospital-level factors). We identified 2,798,225 AMI hospitalizations (≥18 years) with 1,567,575 …

Call To Action: Sars-Cov-2 And Cerebrovascular Disorders (Cascade), Shahram Abootalebi, Benjamin M. Aertker, Mohammad Sobhan Andalibi, Negar Asdaghi, Ozlem Aykac, M. Reza Azarpazhooh, M. Cecilia Bahit, Kristian Barlinn, Hamidon Basri, Reza Bavarsad Shahripour, Anna Bersano, Jose Biller, Afshin Borhani-Haghighi, Robert D. Brown, Bruce Cv Campbell, Salvador Cruz-Flores, Deidre Anne De Silva, Mario Di Napoli, Afshin A. Divani, Randall C. Edgell, Johanna T. Fifi, Abdoreza Ghoreishi, Teruyuki Hirano, Keun Sik Hong, Chung Y. Hsu, Josephine F. Huang, Manabu Inoue, Amanda L. Jagolino, Moira Kapral, Hoo Fan Kee, Zafer Keser, Rakesh Khatri

Epidemiology and Biostatistics Publications

Background and purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. Methods: This is an international, multicenter, hospital-based …

The Risk Of New-Onset Epilepsy And Refractory Epilepsy In Older Adult Stroke Survivors, Jorge G. Burneo, Tresah C. Antaya, Britney N. Allen, Andrea Belisle, Salimah Z. Shariff, Gustavo Saposnik

Neuroepidemiology Research Unit Project Summaries

Research Summary: Key Findings

• Stroke is a common cause of epilepsy in older adults, but little is known about stroke-related epilepsy or its outcomes in this population.
• 1.1% of older adult stroke survivors developed epilepsy in this study, of whom 12.9% developed refractory epilepsy, indicating that this population is particularly responsive to treatment.
• Over 85% of deaths in this population are not due to stroke or epilepsy.

The Incidence And Characteristics Of Stroke In Urban-Dwelling Iranian Women, Amin Amiri Md, Moira Kapral Md Msc, Amanda G. Thrift Phd, Luciano A. Sposato, Hamidreza Saber Md, Reza Behrouz Do Phd, Mahdiyeh Erfanian, Mohammad Taghi Farzadfard Md, Naghmeh Mokhber Md, Reza Azarpazhooh Md

Anatomy and Cell Biology Publications

Background: Population-based data regarding stroke among women are scarce in developing countries. This study was designed to determine whether sex differences exist in stroke incidence, mortality, and recurrence.

Methods: The Mashhad Stroke Incidence Study is a population-based cohort study in Iran. For a period of 1 year, all patients with stroke in 3 geographical regions in Mashhad were recruited and then followed up for 5 years. Age- and sex-specific crude incidence rates were standardized to the World Health Organization New World Population. Male-to-female incidence rate ratios were assessed for all age groups and all subtypes of first-ever stroke (FES). …

Methotrexate And Cardiovascular Events, Alpesh Shah

Electronic Thesis and Dissertation Repository

We conducted a systematic review and meta-analysis to assess the association of MTX with cardiovascular morbidity, cardiovascular mortality and all-cause mortality in patients with autoimmune disease. Our primary outcome was incident cardiovascular events. After screening 13,479 citations, we identified a total of 30 eligible studies. We synthesized adjusted risk estimates using a random effects model. MTX was significantly associated with a 25% reduction in cardiovascular events (pooled RR: 0.75, 95% CI: 0.65, 0.86, I²: 11%), a 55% reduction in cardiovascular mortality (0.45, 95% CI: 0.26, 0.80, I²: 33%) and a 40% reduction in all-cause mortality (0.60, …

Suicide In Young Men, Alexandra Pitman, Karolina Krysinska, Michael King

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

The First Year Counts: Cancer Survival Among Indigenous And Non-Indigenous Queenslanders, 1997–2006, Susanna M. Cramb, Gall Garvey, Patricia C. Valery, John D. Williamson, Peter D. Baade

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine the differential in cancer survival between Indigenous and non-Indigenous people in Queensland in relation to time after diagnosis, remoteness and area-socioeconomic disadvantage.

Design, setting and participants: Descriptive study of population-based data on all 150 059 Queensland residents of known Indigenous status aged 15 years and over who were diagnosed with a primary invasive cancer during 1997–2006.

Main outcome measures: Hazard ratios for the categories of area- socioeconomic disadvantage, remoteness and Indigenous status, as well as conditional 5-year survival estimates.

Results: Five-year survival was lower for Indigenous people diagnosed with cancer (50.3%; 95% CI, 47.8%–52.8%) compared with non-Indigenous …

Metabolic Syndrome And Incident Coronary Heart Disease In Australian Indigenous Populations, Ming Li, Brad Mcculloch, Robyn Mcdermott

Aboriginal Policy Research Consortium International (APRCi)

This report aims to compare the prediction of the metabolic syndrome (MetS) and its components for morbidity and mortality of coronary heart disease (CHD) in a cohort of Australian Aboriginal and Torres Strait Islander adults (TSIs). A total of 2,100 adults (1,283 Aborigines and 817 TSIs) was followed up for 6 years from 2000. Outcome measures were all CHD events (deaths and hospitalizations). Baseline anthropometric measurements, blood pressure (BP), fasting blood lipids and glucose were collected. Smoking and alcohol intake was self-reported. We found MetS was more prevalent in TSI (50.3%) compared to Aborigines (33.0%). Baseline MetS doubled the risk …

Indigenous Beliefs About Biomedical And Bush Medicine Treatment Efficacy For Indigenous Cancer Patients: A Review Of The Literature, K. D. Schaik, S. C. Thompson

Aboriginal Policy Research Consortium International (APRCi)

Background: Australia’s Indigenous people suffer from higher cancer mortality than non-Indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non-Indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both ‘bush medicine’ and biomedical, in order to provide recommendations to healthcare providers about accommodating Indigenous beliefs when treating cancer.

Methods: A search was undertaken of peer-reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions. Results: Literature suggests that Indigenous beliefs …

Counting The Cost: Estimating The Number Of Deaths Among Recently Released Prisoners In Australia, Stuart A. Kinner, David B. Preen, Azar Kariminia, Tony Butler, Jessica Y. Andrews, Mark Stoové, Matthew Law

Aboriginal Policy Research Consortium International (APRCi)

Objective: To estimate the number of deaths among people released from prison in Australia in the 2007–08 financial year, within 4 weeks and 1 year of release. Design, participants and setting: Application of crude mortality rates for ex-prisoners (obtained from two independent, state-based record-linkage studies [New South Wales and Western Australia]) to a national estimate of the number and characteristics of people released from prison in 2007–08. Main outcome measures: Estimated number of deaths among adults released from Australian prisons in 2007–08, within 4 weeks and 1 year of release, classified by age, sex, Indigenous status and cause of death. …

Cancer Incidence And Mortality In Indigenous Australians In Queensland, 1997–2006, Suzanne P. Moore, Peter K. O'Rourke, Kylie-Ann Mallitt, Gail Garvey, Adèle C. Green, Michael D. Coory, Patricia C. Valery

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine cancer incidence and mortality in Indigenous Queenslanders. Design, setting and patients: Assessment of indirectly standardised incidence and mortality ratios for Indigenous Australians in Queensland diagnosed with cancer from 1997 to 2006, compared with the total Queensland population. Main outcome measures: Standardised incidence and mortality ratios. Results: Compared with the total Queensland population, Indigenous Queenslanders had a lower overall incidence of cancer (standardised incidence ratio, 0.79; 95% CI, 0.75–0.82), but a higher incidence of some of the more fatal cancer types. Overall cancer mortality was higher (standardised mortality ratio, 1.36; 95% CI, 1.28–1.45) and similar to rates for …

Birthweight And Natural Deaths In A Remote Australian Aboriginal Community, Wendy E. Hoy, Jennifer L. Nicol

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To describe associations between birthweight and infant, child and early adult mortality from natural causes in a remote Australian Aboriginal community against a background of rapidly changing mortality due to better health services. Design, participants and setting: Cohort study of 995 people with recorded birthweights who were born between 1956 and 1985 to an Aboriginal mother in a remote Australian Aboriginal community. Participants were followed through to the end of 2006. Main outcome measures: Rates of natural deaths of infants (aged 0 to < 1 year), children (aged 1 to < 15 years) and adults (aged 15 to < 37 years), compared by birth intervals (1956–1965, 1966–1975 and 1976–1985 for infants and children, and 1956–1962 and 1963–1969 for adults) and by birthweight. Results: Birthweights were low, but increased over time. Deaths among infants and children decreased dramatically over time, but deaths among adults did not. Lower birthweights were associated with higher mortality. Adjusted for birth interval, hazard ratios for deaths among infants, children and adults born at weights below their group birthweight medians were 2.30 (95% CI, 1.13–4.70) ), 1.78 (95% CI, 1.03–3.07) and 3.49 (95% CI, 1.50–8.09), respectively. The associations were significant individually for deaths associated with diarrhoea in infants, with cardiovascular and renal disease in adults, and marginally significant for deaths from pulmonary causes in children and adults. Conclusion: The striking improvements in infant and child survival over time must be applauded. We confirmed a predisposing effect of lower birthweights on deaths in infants and children, and showed, for the first time, an association between lower birthweights and deaths in adults. Together, these factors are probably contributing to the current epidemic of chronic disease in Aboriginal people, an effect that will persist for decades. Similar phenomena are probably operating in developing countries.

Lower Than Expected Morbidity And Mortality For An Australian Aboriginal Population: 10-Year Follow-Up In A Decentralised Community, Kevin G. Rowley, Kerin O'Dea, Ian Anderson, Robyn Mcdermott, Karmananda Saraswati, Ricky Tilmouth, Iris Roberts, Joseph Fitz, Zaimin Wang, Alicia Jenkins, James D. Best, Zhiqiang Wang, Alex Brown

Aboriginal Policy Research Consortium International (APRCi)

Objective: Toexaminemortalityfromallcausesandfromcardiovasculardisease(CVD), and CVD hospitalisation rate for a decentralised Aboriginal community in the Northern Territory. Design and participants: For a community-based cohort of 296 people aged 15 years or older screened in 1995, we reviewed hospital and primary health care records and death certificates for the period up to December 2004 (2800 person-years of follow-up). Mainoutcomemeasures: MortalityfromallcausesandCVD,andhospitalisationwith CVD coded as a primary cause of admission; comparison with prior trends (1988 to 1995) in CVD risk factor prevalence for the community, and with NT-specific Indigenous mortality and hospitalisation rates.

Results: Mortality in the cohort was 964/100 000 person-years, significantly lower than …

Long-Term Trends In Indigenous Deaths From Chronic Diseases In The Northern Territory: A Foot On The Brake, A Foot On The Accelerator, David P. Thomas, John R. Condon, Ian P. Anderson, Shu Q. Li, Stephen Halpin, Joan Cunningham, Steven L. Guthridge

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine trends in Northern Territory Indigenous mortality from chronic diseases other than cancer. Design: A comparison of trends in rates of mortality from six chronic diseases (ischaemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], cerebrovascular disease [CVD], diabetes mellitus [DM], renal failure [RF] and rheumatic heart disease [RHD]) in the NT Indigenous population with those of the total Australian population.

Participants: NT Indigenous and total Australian populations, 1977–2001. Main outcome measures: Estimated average annual change in chronic disease mortality rates and in mortality rate ratios. Results: DeathratesfromIHDandDMamongNTIndigenouspeoplesincreased between 1977 and 2001, but this increase slowed after 1990. …

Stage At Diagnosis And Cancer Survival For Indigenous Australians In The Northern Territory, John R. Condon, Tony Barnes, Bruce K. Armstrong, Sid Selva-Nayagam, J. Mark Elwood

Aboriginal Policy Research Consortium International (APRCi)

Objective: To investigate whether Indigenous Australians with cancer have more advanced disease at diagnosis than other Australians, and whether late diagnosis explains lower Indigenous cancer survival rates. Design: Retrospective cohort study.

Setting and participants: Indigenous and non-Indigenous people diagnosed with cancers of the colon and rectum, lung, breast or cervix and non-Hodgkin lymphoma in the Northern Territory of Australia in 1991–2000. Main outcome measures: SEER summary stage of cancer at diagnosis (local, regional or distant spread), cause-specific cancer survival rates and relative risk of cancer death.

Results: Diagnosis with advanced disease (regional or distant spread) was more common for Indigenous …