Medicine and Health Sciences Commons^™

Examining The Relationship Of Blood Transfusions And Acute Morbidity In Preterm Infants, Kayla Chavis Everhart

Theses and Dissertations

Preterm infants, those that are born less than 37 weeks gestational age, often suffer major morbidity and mortality during hospitalization in the neonatal intensive care unit due to their prematurity; one of the major morbidities is Necrotizing Enterocolitis, a devastating gastrointestinal disease. The exact aspects that cause preterm infants to develop Necrotizing Enterocolitis are unknown; however, our hypothesis is preterm infant thermal stability and/or preterm infant stress around packed red blood cell transfusions are etiological factors in the relationship between these necessary transfusions and morbid outcomes such as Necrotizing Enterocolitis.This dissertation includes an in-depth background and introduction of various morbid …

Impact Of Follow Up Blood Cultures On Outcomes Of Patients With Community-Onset Gram-Negative Bloodstream Infection, Rajiv Amipara, Hana Rac Winders, Julie Ann Justo, P Brandon Bookstaver, Joseph Kohn, Majdi N. Al-Hasan

Faculty Publications

Background: The role of follow up blood cultures (FUBC) in the management of gram-negative bloodstream infection (GN-BSI) remains controversial. This retrospective cohort study examines the association between obtaining FUBC and mortality in GN-BSI. Methods: Hospitalized adults with community-onset GN-BSI at Prisma Health-Midlands hospitals in South Carolina, USA from January 1, 2010 to June 30, 2015 were identified. Patients who died or were discharged from hospital within 72 h were excluded to minimize impact of survival and selection biases on results, respectively. Multivariate Cox proportional hazards regression was used to examine association between obtaining FUBC and 28-day all-cause mortality after adjustment …

Regional Distribution Of Covid-19 Mortality In Peru, Maria Flores López, Alonso Soto Tarazona, Jhony A. De La Cruz-Vargas

Revista de la Facultad de Medicina Humana

Objectives: Compare the death rate from COVID-19 at the national level by regions and departments from March to September 2020. Methods: Quantitative, observational, cross-sectional, ecological and retrospective study. The data was extracted from the National Death System (SINADEF) in Microsoft Excel 2016 and imported into Stata. The variables were described as frequencies and percentages. Mortality was obtained by dividing the total deaths over the total population according to the last census. An adjusted exploratory analysis was performed using robust regression methods to evaluate the association between mortality by department and regions adjusted for age and sex of the deceased. P <0.05 was considered significant. Results: 32535 deaths were reported, 69.84% were male and the median was 67. The mortality rate in the Costa region 145 deaths were calculated (n = 24,276), followed by Sierra with 51 (n = 4434) and Selva with 63 (n = 2545). There were significant differences in mortality according to the region, in the comparison of the coast with the Sierra region a beta coefficient of -96.28 was found (p <0.001 IC -123.76 -68.77), while in the comparison with the Selva it was determined a coefficient of -50.38 (p 0.01 95% CI -91.47 -9.29). No significant association was found between the mortality rate and the average age or sex of the deceased by department. Conclusion: The death rate from COVID-19 at the national level was 101 per 100 000 inhabitants. The mortality rate found was higher on the Costa region than in the Sierra and Selva, regardless of the proportion of men, women or age.

Association Between Vitamin D Deficiency And Sepsis In Pediatric Icu, Ahmed A. Khattab, Aliaa A. Abdel-Aziz, Fady M. El-Gendy, Rehab G. Naser

Menoufia Medical Journal

Objective To evaluate association between 25-hydroxyvitamin D [25(OH)D] and sepsis in pediatric ICU (PICU). Background Vitamin D is a fat-soluble steroid hormone that helps maintain proper calcium homeostasis and has a role in the function of the immune system. Data on the prevalence of vitamin D deficiency (VDD) in PICU in children with sepsis and its association with poor outcome were obtained. Patients and methods This study was carried out on 45 patients with sepsis admitted to the PICU, Pediatric Department, Menoufia University Hospital, and 45 controls, who attended the patient clinic and were found to be healthy. Demographic data, …

Anemia And Cancer Survival, A Peruvian Study With A 5-Year Follow-Up, María Loo-Valverde, Jennyfer E. Garcia Arispe, Willer Chanduví, Jose M. Vela-Ruiz, Rocio Guillen-Ponce, Jhony A. De La Cruz-Vargas

Revista de la Facultad de Medicina Humana

Introduction: Anemia is a serious public health. Several studies indicate that anemia status is a factor that might influence survival and response to cancer treatment in patients. Objective: To determine the relationship between anemia and 5-year survival in cancer patients. Methods: Observational, analytical, and retrospective cohort study. The sample population consisted of novel diagnosed cancer patients registered for hospital care with their respective follow up from 2014 until 2019. Time to death, presence of anemia, and other variables were evaluated. Survival was determined using Kaplan Meier curves and analyzed using the log-rank test. Hazard ratio and risk were determined in …

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 …

Hypoalbuminemia As A Predicator Of Mortality Of Sepsis From Covid-19. Hospital Ii Chocope, 2020., Alex Brandon Lopez, Graciela Aguilar Murillo, Alicia Muñoz Neciosup, Evelyn Goicochea Rios

Revista de la Facultad de Medicina Humana

A correlational type investigation was carried out evaluating 145 patients with covid-19 sepsis. Objectives: To determine whether hypoalbuminemia is a predictor of mortality and to identify the serum albumin value most frequently related to lethality. Method: Patients older than or equal to 18 years seen at Hospital II Chocope during May to August 2020 were included. Patients with oncological pathologies and incomplete medical records were excluded. The documentary analysis technique was used, by reviewing medical records. Results: There was a statistically significant association between hypoalbuminemia and mortality (p = 0.00), patients with hypoalbuminemia had 3 times the risk of dying. …

Border Epidemiological Study Of Aging: The Role Of Psychosocial Factors On Mortality Of Mexican Americans In South Texas, Raed Jannadi

FIU Electronic Theses and Dissertations

Despite Mexican Americans experiencing many chronic illnesses, e.g., diabetes and obesity, they exhibit higher life expectancy than other population groups in the United States. This is known as the Hispanic Paradox. This dissertation aimed to further contribute to the literature on the “paradox” by investigating the association between psychosocial factors rarely investigated in this population, such as social support, self- rated health, and stressful life events, with incident diabetes and all-cause mortality.

Data for this dissertation are from the Border Epidemiological Study of Aging, known as BESA, a population based longitudinal study consisting of four waves conducted in South Texas …

Relationship Between Diet Quality Scores And The Risk Of Frailty And Mortality In Adults Across A Wide Age Spectrum, Kulapong Jayanama, Olga Theou, Judith Godin, Leah Cahill, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert, Michael David Wirth Msph, Phd, Yong-Moon Park, Teresa T. Fung, Kenneth Rockwood

Faculty Publications

Background

Beyond intakes of total energy and individual nutrient, eating patterns may influence health, and thereby the risk of adverse outcomes. How different diet measures relate to frailty—a general measure of increased vulnerability to unfavorable health outcomes—and mortality risk, and how this might vary across the life course, is not known. We investigated the associations of five dietary indices (Nutrition Index (NI), the energy-density Dietary Inflammatory Index (E-DII™), Healthy Eating Index-2015 (HEI-2015), Mediterranean Diet Score (MDS), and Dietary Approaches to Stop Hypertension (DASH)) with frailty and mortality.

Methods

We included 15,249 participants aged ≥ 20 years from the 2007–2012 cohorts …

Bovine Lactoferrin To Prevent Neonatal Infections In Low-Birth-Weight Newborns In Pakistan: Protocol For A Three-Arm Double-Blind Randomized Controlled Trial, Shabina Ariff, Sajid Bashir Soofi, Almas Aamir, Michelle D'Almeida, Arzina Aziz Ali, Ashraful Alam, Michael Dibley

Department of Paediatrics and Child Health

Background: Sepsis is a common and severe complication in premature neonates, particularly those born with low birth weights (<2500 >g). Neonatal sepsis is steadily emerging as a leading cause of neonatal mortality in Pakistan. Lactoferrin is a natural product with broad-spectrum antimicrobial properties and glycoprotein that is actively involved in innate immune host responses. Clinical trials have revealed its protective effect on sepsis, but lactoferrin dosage, duration, and role in the prevention of sepsis are still uncertain.
Objective: We aimed to establish the efficacy of bovine lactoferrin in the prevention of late-onset sepsis and to determine the optimal dose and …

Neurological Complications Of Covid19 During March 2020 At Lcmc Health University Medical Center: Dataset, David Chachkhiani, Michael Y. Soliman, Delphi Barua, Marine Isakadze, Nicole R. Villemarette-Pittman, Deidre J. Devier, Jesus F. Lovera

School of Medicine Faculty Publications

We reviewed the electronic medical records (EMR) of patients hospitalized during the peak of the pandemic, March 1st through March 31st, to document the type and frequency of neurological problems seen in patients with COVID-19 at presentation to the emergency room. Secondary aims were to determine: 1) the frequency of neurological complaints during the hospital stay; 2) whether the presence of any neurological complaint at presentation or any of the individual types of neurological complaints at admission predicted three separate outcomes: death, length of hospital stay, or the need for intubation; and 3) if the presence of any neurological complaint …

Mortalidad Por Infarto Agudo De Miocardio En Guatemala 2018: Patrones E Inequidades, Alejandro Cerón, Gila Goldstein

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por infarto agudo de miocardio (IAM) en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir de IAM en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo de morir de IAM. …

Evaluation Of Serum Ferritin For Prediction Of Severity And Mortality In Covid-19- A Cross Sectional Study, Sibtain Ahmed, Zeeshan Ansar Ahmed, Imran Siddiqui, Naveed Haroon Rashid, Maheen Mansoor, Lena Jafri

Department of Pathology and Laboratory Medicine

Background: Ferritin even though widely recognized as a representative of total body iron stores, its prognostic utility is linked with COVID-19. This study was aimed at evaluation of the association of ferritin with severity in Coronavirus disease 2019 (COVID-19), hospitalized patients and to test the hypothesis that it is an independent predictor of mortality.
Material and methods: This study was conducted at Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi. Medical records of all in-patients including both genders, and all age groups with documented COVID-19 from 1st March to 10^th August 2020 were reviewed. …

Relative And Absolute Risk To Guide The Management Of Pulse Pressure, An Age-Related Cardiovascular Risk Factor, Jesus D. Melgarejo, Lutgarde Thijs, Dong-Mei Wei, Michael Bursztyn, Wen-Yi Yang, Yan Li, Kei Asayama, Tine W. Hansen, Masahiro Kikuya, Gladys E. Maestre, Benjamin Gavish

School of Medicine Publications and Presentations

BACKGROUND Pulse pressure (PP) reflects the age-related stiffening of the central arteries, but no study addressed the management of the PP-related risk over the human lifespan.

METHODS In 4663 young (18-49 years) and 7185 older adults (≥50 years), brachial PP was recorded over 24-hour. Total mortality and all major cardiovascular events combined (MACE) were co-primary endpoints. Cardiovascular death, coronary events and stroke were secondary endpoints.

RESULTS In young adults (median follow-up, 14.1 years; mean PP, 45.1 mmHg), greater PP was not associated with absolute risk; the endpoint rates were ≤2.01 per 1000 person-years. The adjusted hazard ratios expressed per 10-mmHg …

Declining Intensive Care Unit Mortality Of Covid-19: A Multi-Center Study, Sohaib Roomi, Syed Omar Shah, Waqas Ullah, Shan Abedin, Karyn L. Butler, Chiers, Kelly, Benjamin A. Kohl, Erika J. Yoo, Matthew Vibbert, Jack Jallo

Department of Surgery Faculty Papers

Background: Coronavirus disease 2019 (COVID-19) mortality has waned significantly over time; however, factors contributing towards this reduction largely remain unidentified. The purpose of this study was to evaluate the trend in mortality at our large tertiary academic health system and factors contributing to this trend. Methods: This is a retrospective cohort study of intensive care unit (ICU) patients diagnosed with COVID-19 between March and August 2020 admitted across 14 hospitals in the Philadelphia area. Collected data included demographics, comorbidities, admission risk of mortality score, laboratory values, medical interventions, survival outcomes, hospital and ICU length of stay (LOS) and discharge disposition. …

Effect Of Aspirin On Cancer Incidence And Mortality In Older Adults, John J Mcneil, Yin Cao, Et Al.

2020-Current year OA Pubs

BACKGROUND: ASPirin in Reducing Events in the Elderly, a randomized, double-blind, placebo-controlled trial of daily low-dose aspirin (100 mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast, prior randomized controlled trials, mainly involving younger individuals, demonstrated a delayed cancer benefit with aspirin. We now report a detailed analysis of cancer incidence and mortality.

METHODS: 19 114 Australian and US community-dwelling participants aged 70 years and older (US minorities 65 years and older) without cardiovascular disease, dementia, or physical disability were randomly assigned and followed for a median of 4.7 years. Fatal and nonfatal …

Impact Of Social Isolation On Mortality And Morbidity In 20 High-Income, Middle-Income And Low-Income Countries In Five Continents, Ryo Naito, Darryl P. Leong, Shrikant Ishve Bangdiwala, Martin Mckee, S V. Subramanian, Sumathy Rangarajan, Shofiqul Islam, Alvaro Avezum, Karen E. Yeates, Syed Iqbal Azam

Community Health Sciences

Objective: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries.
Design: Population-based prospective observational study.
Setting: Urban and rural communities in 20 high income, middle income and low income.
Participants: 119 894 community-dwelling middle-aged adults.
Main outcome measures: Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases.
Results: Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and …

Acute Necrotizing Pancreatitis: Has Conservative Management Replaced Surgery? Perspective From A Tertiary Care Centre In Pakistan: A Cross-Sectional Study, Fatima Mannan, Roger Christopher Gill, Abdul Ahad Sohail, Abdul Rehman Alvi, Khabir Ahmad

Department of Surgery

Background: The main purpose of this study was to review the trends in management of patients presenting with acute necrotizing pancreatitis (ANP) over the last seven years and its effect on morbidity and mortality.
Methods: A cross-sectional study was conducted on all patients presenting with the diagnosis of acute necrotizing pancreatitis to the Aga Khan University Hospital in between the year 2008-2015. The study population was broadly categorized in to two groups based on the way these were managed. The first group consisted of patient who underwent surgery for acute necrotizing pancreatitis while the second group was composed of those …

Global Trends In Adolescents' Road Traffic Injury Mortality, 1990-2019, Uzma Rahim Khan, Junaid A. Razzak, Martin Gerdin Wärnberg

Department of Emergency Medicine

Objective: The aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10-14 years and 15-19 years across different country income levels with respect to the type of road users from 1990 to 2019.
Methods: We conducted an ecological study. Adolescents' mortality rates from RTIs at the level of high-income countries (HICs), upper-income to middle-income countries (UMICs), lower-income to middle-income countries and low-income countries were extracted from the Global Burden of Disease study. Time series were plotted to visualise the trends in mortality rates over the years. We also conducted Poisson regression …

Skin Manifestations In Covid-19 Patients: Are They Indicators For Disease Severity? A Systematic Review, Parnian Jamshidi, Bahareh Hajikhani, Mehdi Mirsaeidi, Hassan Vahidnezhad, Masoud Dadashi, Mohammad Javad Nasiri

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction: Until now, there are several reports on cutaneous manifestations in COVID-19 patients. However, the link between skin manifestations and the severity of the disease remains debatable. We conducted a systematic review to evaluate the temporal relationship between different types of skin lesions and the severity of COVID-19. Methods: A systematic search was conducted for relevant studies published between January and July 2020 using Pubmed/Medline, Embase, and Web of knowledge. The following keywords were used: "SARS-CoV-2" or "COVID-19" or "new coronavirus" or "Wuhan Coronavirus" or "coronavirus disease 2019" and "skin disease" or "skin manifestation" or "cutaneous manifestation." Results: Out of …

Risk Factors Associated With A Second Primary Lung Cancer In Patients With An Initial Primary Lung Cancer, Amanda D. Fisher, Seongho Kim Phd, Dina Farhat, Kimberly Belzer, Maryann Milczuk, Courtney French, Hirva Mamdani Md, Ammar Sukari Md, Frank Baciewicz Md, Ann G. Schwartz Phd, Mph, Antoinette Wozniak Md, Misako Nagasaka Md

Medical Student Research Symposium

Objectives: Increased patient survivorship following initial primary lung cancer (IPLC) due to advancing clinical practice has uncovered new clinical challenges. With growing patient longevity, individuals post-IPLC continue to be at higher subsequent risk of developing secondary primary lung cancer (SPLC). Proper SPLC surveillance guidelines aimed at monitoring IPLC survivors is crucial to enhancing life expectancy in this population. This study aims to categorize risk factors associated with SPLC emergence in IPLC survivors for clinical use following IPLC treatment.

Materials and Methods: Using the Karmanos Cancer Institute Tumor Registry, patients diagnosed with IPLC from 2000 to 2017 were identified. …

Opioids And Sickle Cell Disease: From Opium To The Opioid Epidemic., Samir K. Ballas

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is an inherited disorder of hemoglobin structure. The clinical effects of the sickle gene are pleiotropic in nature causing multiple phenotypic expressions associated with the various complications of the disease. The hallmark of the disease is pain that could be acute, chronic, nociceptive, or neuropathic that could occur singly or in various combinations. The acute vaso-occlusive painful crisis (VOC) is the most common cause of admissions to the Emergency Department and/or the hospital. Although progress has been made in understanding the pathophysiology of SCD as well as in developing preventive and curative therapies, effective pain management …

Associations Between Demographic Factors And Suicide Deaths In Vermont: 2015-2019, Isabelle Tomanelli, Lucy Lincoln, Stephanie Stead, Mary Ryan-Eldred, Nick Martin, Sarah Vose

Master of Public Health Culminating Projects

Objectives. To quantify the complex relationships shared between numerous risk factors associated with suicide among Vermont decedents.

Methods. Vermont Electronic Death Registration System (EDRS) data from 2015-2019 were examined through binary logistic regression analyses to examine demographic variables’ ability to predict death by suicide.

Results. In the analysis of 26,738 deaths, significant predictors of suicide among the 535 suicide decedents included rurality (odds ratio [OR] = 1.043; 95% CI = 1.016, 1.071; P = 0.002), divorce (OR = 1.785; 95% CI = 1,396, 2.281; P < 0.001), and higher educational attainment including associate degree (OR = 1.472; 95% CI = 1.033, 2.098; P = 0.032), bachelor’s degree (OR = 1.686; 95% CI = 1.266, 2.247; P < 0.001), master’s degree (OR = 1.812; 95% CI = 1.162, 2.826; P …