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Articles 1 - 30 of 153

Full-Text Articles in Diseases

Detecting, Preventing, And Treating Sexually Transmitted Diseases Among Adolescent Arrestees: An Unmet Public Health Need, Christopher Salvatore, Steven Belenko, Richard Dembo, Matthew Rollie, Kristina Childs Oct 2019

Detecting, Preventing, And Treating Sexually Transmitted Diseases Among Adolescent Arrestees: An Unmet Public Health Need, Christopher Salvatore, Steven Belenko, Richard Dembo, Matthew Rollie, Kristina Childs

Christopher Salvatore

Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the “front end” of the juvenile justice system that is detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD …


Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard Jul 2019

Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard

Gyongyi Szabo

Introduction: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients is a poor prognostic factor after liver transplantation and/or resection. Any correlation between MVI and segmental location of HCC has yet to be studied. Our aim is to evaluate the segmental location of HCC and any correlation with the presence of MVI, portal vein thrombosis (PVT) in explanted livers, and the recurrence of HCC after transplantation. Another objective of the study is to assess the treatment history (ablation or transarterial chemoembolization (TACE)) and size of the tumor with respect to the risk of MVI.

Methods: A single center, retrospective chart review, …


Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. Mcmanus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane Jul 2019

Changes In Anticoagulant Utilization Among United States Nursing Home Residents With Atrial Fibrillation From 2011 To 2016, Matthew Alcusky, David D. Mcmanus, Anne L. Hume, Marc Fisher, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Background: Nursing home residents with atrial fibrillation are at high risk for ischemic stroke and bleeding events. The most recent national estimate (2004) indicated less than one third of this high-risk population was anticoagulated. Whether direct-acting oral anticoagulant ( DOAC ) use has disseminated into nursing homes and increased anticoagulant use is unknown.

Methods and Results: A repeated cross-sectional design was used to estimate the point prevalence of oral anticoagulant use on July 1 and December 31 of calendar years 2011 to 2016 among Medicare fee-for-service beneficiaries with atrial fibrillation residing in long-stay nursing homes. Nursing home residence was determined …


High Burden Of Unrecognized Atrial Fibrillation In Rural India: An Innovative Community-Based Cross-Sectional Screening Program, Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael S. Chin, John Stephen Sullivan, Shyamsundar Raithatha, Robert J. Goldberg, Somashekhar Nimbalkar, Jeroan J. Allison, Sunil Thanvi, David D. Mcmanus May 2019

High Burden Of Unrecognized Atrial Fibrillation In Rural India: An Innovative Community-Based Cross-Sectional Screening Program, Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael S. Chin, John Stephen Sullivan, Shyamsundar Raithatha, Robert J. Goldberg, Somashekhar Nimbalkar, Jeroan J. Allison, Sunil Thanvi, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation, the world's most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly.

OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor.

METHODS: Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent, a team …


Infant Sleep Problems And Childhood Overweight: Effects Of Three Definitions Of Sleep Problems, Arsham Alamian, Liang Wang, Amber M. Hall, Melanie Pitts, Joseph Ikekwere Feb 2018

Infant Sleep Problems And Childhood Overweight: Effects Of Three Definitions Of Sleep Problems, Arsham Alamian, Liang Wang, Amber M. Hall, Melanie Pitts, Joseph Ikekwere

Arsham Alamian

Sleep problems have been defined using a variety of definitions. No study has assessed the longitudinal association between infant sleep problems and childhood overweight or obesity using existing definitions of sleep problems. This study used longitudinal data (n=895) from the multi-site Study of Early Child Care and Youth Development (SECCYD) to investigate the effects of infant sleep problems on childhood weight status in Grade 6. Infants with sleep problems in Phase I (1991) and with complete data through Phase III (2004) of SECCYD were included. Sleep problems were assessed using maternal reports of night wakings and duration of a waking …


Ethnic Differences In Risk Factors For Obesity Among Adults In California, The United States, Liang Wang, Jodi L. Southerland, Kesheng Wang, Beth A. Bailey, Arsham Alamian, Marc A. Stevens, Youfa Want Feb 2018

Ethnic Differences In Risk Factors For Obesity Among Adults In California, The United States, Liang Wang, Jodi L. Southerland, Kesheng Wang, Beth A. Bailey, Arsham Alamian, Marc A. Stevens, Youfa Want

Arsham Alamian

Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese). Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%), Latinos (33.6%), African Americans (36.1%), and Asians (9.8%). Differences in risk factors for obesity were also observed: Whites …


Ten-Year (2001-2011) Trends In The Incidence Rates And Short-Term Outcomes Of Early Versus Late Onset Cardiogenic Shock After Hospitalization For Acute Myocardial Infarction, Hoa L. Nguyen, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, David D. Mcmanus, Robert J. Goldberg Dec 2017

Ten-Year (2001-2011) Trends In The Incidence Rates And Short-Term Outcomes Of Early Versus Late Onset Cardiogenic Shock After Hospitalization For Acute Myocardial Infarction, Hoa L. Nguyen, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, David D. Mcmanus, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Cardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population-based perspective. Our study objectives were to describe decade-long trends in the incidence, in-hospital mortality, and factors associated with the development of CS in 3 temporal contexts: (1) before hospital arrival for acute myocardial infarction (prehospital CS); (2) within 24 hours of hospitalization (early CS); and (3) > /=24 hours after hospitalization (late CS). METHODS AND RESULTS: The study population consisted of 5782 …


Pain And Pharmacologic Pain Management In Long-Stay Nursing Home Residents, Jacob N. Hunnicutt, Christine M. Ulbricht, Jennifer Tjia, Kate L. Lapane May 2017

Pain And Pharmacologic Pain Management In Long-Stay Nursing Home Residents, Jacob N. Hunnicutt, Christine M. Ulbricht, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Prior studies estimate that >40% of long-stay nursing home (NH) residents experience persistent pain, with 20% of residents in pain receiving no analgesics. Strengthened NH surveyor guidance and improved pain measures on the Minimum Data Set (MDS) 3.0 were introduced in March 2009 and October 2010, respectively. This study aimed to provide estimates after these important initiatives of: 1) prevalence and correlates of persistent pain; and 2) prevalence and correlates of untreated or undertreated persistent pain. We identified 1,387,405 long-stay residents in United States NHs between 2011-2012 with 2 MDS assessments 90 days apart. Pain was categorized as persistent (pain …


The Association Of Calcium Intake And Other Risk Factors With Cardiovascular Disease Among Obese Adults In Usa, Yang Chen, Sheryl Strasser, Katie Callahan, David Blackley, Yan Cao, Liang Wang, Shimin Zheng May 2017

The Association Of Calcium Intake And Other Risk Factors With Cardiovascular Disease Among Obese Adults In Usa, Yang Chen, Sheryl Strasser, Katie Callahan, David Blackley, Yan Cao, Liang Wang, Shimin Zheng

Shimin Zheng

In this study, we used a cross-sectional study design to examine the relationship between the calcium intake and risk factors for CVD among obese adults by using continuous waves of National Health and Nutrition Examination Survey (NHANES) data 1999-2010. The association between calcium intake and risk factors of CVD (hypertension, total cholesterol, HDL, glycohemoglobin), CRP, albuminuria) is assessed among obese adults in USA. The incidence of Cardiovascular Disease (CVD) is high among obese people. The potential effects of inadequate calcium intake on CVD are receiving increased epidemiologic attention. Understanding the association between risk factors for CVD and calcium intake among …


Associations Of Smoking Status And Serious Psychological Distress With Chronic Obstructive Pulmonary Disease, Ke-Sheng Wang, Liang Wang, Shimin Zheng, Long-Yang Wu May 2017

Associations Of Smoking Status And Serious Psychological Distress With Chronic Obstructive Pulmonary Disease, Ke-Sheng Wang, Liang Wang, Shimin Zheng, Long-Yang Wu

Shimin Zheng

Background: Chronic obstructive pulmonary disease (COPD) has been a major public health problem due to its high prevalence, morbidity, and mortality. Smoking is a major risk factor for COPD, while serious psychological distress (SPD) is prevalent among COPD patients. However, no study focusing on the effect of SPD on COPD has been so far conducted, while few studies have focused on the associations of SPD and behavioral factors with COPD by smoking status. Objectives: This study aimed to examine the associations of SPD and behavioral factors (such as smoking and physical activity) with COPD. Materials and Methods: Weighted logistic regression …


Georgia's Collaborative Approach To Expanding Mosquito Surveillance In Response To Zika Virus: A Case Study, R. Christopher Rustin, Deonte Martin, Varadan Sevilimedu, Sarbesh Pandeya, Haresh Rochani, Rosmarie Kelly Apr 2017

Georgia's Collaborative Approach To Expanding Mosquito Surveillance In Response To Zika Virus: A Case Study, R. Christopher Rustin, Deonte Martin, Varadan Sevilimedu, Sarbesh Pandeya, Haresh Rochani, Rosmarie Kelly

R. Christopher Rustin

Background:
Zika virus (ZIKV) was declared an international public health emergency by the World Health Organization on
February 1, 2016. Due to the known and estimated range of the ZIKV mosquito vectors, southern and central US
states faced increased risk of ZIKV transmission. With the state of Georgia hosting the world’s busiest international airport, a climate that supports the ZIKV vectors, and limited surveillance (13 counties) and response capacity, the Department of Public Health (DPH) was challenged to respond and prevent ZIKV transmission. This case study describes and evaluates the state’s surveillance capacity before and after the declaration of ZIKV …


Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg Dec 2016

Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg

Catarina I. Kiefe

OBJECTIVES: The purpose of this study was to examine decade-long trends (2001-2011) in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI) who received a primary percutaneous coronary intervention (PCI).

METHODS: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629). Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department (ED) …


Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg Dec 2016

Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg

Jorge L. Yarzebski

OBJECTIVES: The purpose of this study was to examine decade-long trends (2001-2011) in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI) who received a primary percutaneous coronary intervention (PCI). METHODS: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629). Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department (ED) …


Decade Long Trends (2001-2011) In Duration Of Pre-Hospital Delay Among Elderly Patients Hospitalized For An Acute Myocardial Infarction, Raghavendra Makam, Nathaniel Erskine, Jorge L. Yarzebski, Darleen M. Lessard, Jason Lau, Jeroan J. Allison, Joel M. Gore, Jerry H. Gurwitz, David D. Mcmanus, Robert J. Goldberg Sep 2016

Decade Long Trends (2001-2011) In Duration Of Pre-Hospital Delay Among Elderly Patients Hospitalized For An Acute Myocardial Infarction, Raghavendra Makam, Nathaniel Erskine, Jorge L. Yarzebski, Darleen M. Lessard, Jason Lau, Jeroan J. Allison, Joel M. Gore, Jerry H. Gurwitz, David D. Mcmanus, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Early intervention with medical and/or coronary revascularization treatment approaches remains the cornerstone of the management of patients hospitalized with acute myocardial infarction (AMI). However, several patient groups, especially the elderly, are known to delay seeking prompt medical care after onset of AMI-associated symptoms. Current trends, and factors associated with prolonged prehospital delay among elderly patients hospitalized with AMI, are incompletely understood.

METHODS AND RESULTS: Data from a population-based study of patients hospitalized at all 11 medical centers in central Massachusetts with a confirmed AMI on a biennial basis between 2001 and 2011 were analyzed. Information about duration of prehospital …


Angina Characteristics As Predictors Of Trajectories Of Quality Of Life Following Acute Coronary Syndrome In The Transitions, Risks And Actions In Coronary Events-Center For Outcomes Research And Education Cohort (Trace-Core), Lisa Nobel, Jennifer Tjia, Jane S. Saczynski, Molly E. Waring, Milena D. Anatchkova, Arlene Ash, Catarina I. Kiefe, Jeroan Allison Aug 2016

Angina Characteristics As Predictors Of Trajectories Of Quality Of Life Following Acute Coronary Syndrome In The Transitions, Risks And Actions In Coronary Events-Center For Outcomes Research And Education Cohort (Trace-Core), Lisa Nobel, Jennifer Tjia, Jane S. Saczynski, Molly E. Waring, Milena D. Anatchkova, Arlene Ash, Catarina I. Kiefe, Jeroan Allison

Jennifer Tjia

BACKGROUND: To describe longitudinal trajectories of health-related quality of life (HRQoL) after hospitalization with an acute coronary syndrome (ACS), their associations with baseline angina characteristics, and associations with anxiety, depression, and cognitive impairment.

METHODS: TRACE-CORE participants (N=1,613) completed the SF-36 during hospitalization for ACS and 1, 3, & 6 months post-discharge. Latent growth curves identified trajectories of physical and mental components of HRQOL (MCS and PCS) and sequential multiple logistic regression estimated associations between trajectories and angina characteristics.

RESULTS: Participants (N=1613) had mean age 63.3 (SD 11.4) years, 33.0% female, and 78.2% non-Hispanic white. We identified 2 MCS trajectories: AVERAGE …


Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg May 2016

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all eleven …


Magnitude Of And Prognostic Factors Associated With 1-Year Mortality After Hospital Discharge For Acute Decompensated Heart Failure Based On Ejection Fraction Findings, Andrew H. Coles, Mayra Tisminetzky, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, Chad E. Darling, Robert J. Goldberg Mar 2016

Magnitude Of And Prognostic Factors Associated With 1-Year Mortality After Hospital Discharge For Acute Decompensated Heart Failure Based On Ejection Fraction Findings, Andrew H. Coles, Mayra Tisminetzky, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, Chad E. Darling, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data exist about the magnitude of and the factors associated with prognosis within 1 year for patients discharged from the hospital after acute decompensated heart failure. Data are particularly limited from the more generalizable perspective of a population-based investigation and should be further stratified according to currently recommended ejection fraction (EF) findings.

METHODS AND RESULTS: The hospital medical records of residents of the Worcester, Massachusetts, metropolitan area who were discharged after acute decompensated heart failure from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, 2004, and 2006 were reviewed. The average age of the 4025 …


Decade-Long Trends In 30-Day Rehospitalization Rates After Acute Myocardial Infarction, Han-Yang Chen, Mayra Tisminetzky, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Joel Gore, Robert J. Goldberg Feb 2016

Decade-Long Trends In 30-Day Rehospitalization Rates After Acute Myocardial Infarction, Han-Yang Chen, Mayra Tisminetzky, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Joel Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: There are limited data available describing relatively contemporary trends in 30-day rehospitalizations among patients who survive hospitalization after an acute myocardial infarction (AMI) in the community setting. We examined decade-long (2001-2011) trends in, and factors associated with, 30-day rehospitalizations in patients discharged from 3 central Massachusetts hospitals after AMI. METHODS AND RESULTS: Residents of the Worcester, MA, metropolitan area discharged after AMI from 3 central Massachusetts hospitals on a biennial basis between 2001 and 2011 comprised the study population (N=4810). Logistic regression analyses were used to examine the association between selected factors and 30-day rehospitalizations. The average age of …


Characteristics Of Contemporary Patients Discharged From The Hospital After An Acute Coronary Syndrome, Robert Goldberg, Jane Saczynski, David Mcmanus, Molly Waring, Richard Mcmanus, Jeroan Allison, David Parish, Darleen Lessard, Sharina Person, Joel Gore, Catarina Kiefe Aug 2015

Characteristics Of Contemporary Patients Discharged From The Hospital After An Acute Coronary Syndrome, Robert Goldberg, Jane Saczynski, David Mcmanus, Molly Waring, Richard Mcmanus, Jeroan Allison, David Parish, Darleen Lessard, Sharina Person, Joel Gore, Catarina Kiefe

Richard H. McManus

BACKGROUND: Limited contemporary data compare the clinical and psychosocial characteristics and acute management of patients hospitalized with an initial vs a recurrent episode of acute coronary disease. We describe these factors in a cohort of patients recruited from 6 hospitals in Massachusetts and Georgia after an acute coronary syndrome. MATERIALS AND METHODS: We performed structured baseline in-person interviews and medical record abstractions for 2174 eligible and consenting patients surviving hospitalization for an acute coronary syndrome between April 2011 and May 2013. RESULTS: The average patient age was 61 years, 64% were men, and 47% had a high school education or …


The Spatial Dynamics Of Dengue Virus In Kamphaeng Phet, Thailand, Piraya Bhoomiboonchoo, Robert V. Gibbons, Angkana Huang, In-Kyu Yoon, Darunee Buddhari, Ananda Nisalak, Natkamol Chansatiporn, Mathuros Thipayamongkolgul, Siripen Kalanarooj, Timothy Endy, Alan L. Rothman, Anon Srikiatkhachorn, Sharone Green, Mammen P. Mammen, Derek A. Cummings, Henrik Salje Jul 2015

The Spatial Dynamics Of Dengue Virus In Kamphaeng Phet, Thailand, Piraya Bhoomiboonchoo, Robert V. Gibbons, Angkana Huang, In-Kyu Yoon, Darunee Buddhari, Ananda Nisalak, Natkamol Chansatiporn, Mathuros Thipayamongkolgul, Siripen Kalanarooj, Timothy Endy, Alan L. Rothman, Anon Srikiatkhachorn, Sharone Green, Mammen P. Mammen, Derek A. Cummings, Henrik Salje

Sharone Green

BACKGROUND: Dengue is endemic to the rural province of Kamphaeng Phet, Northern Thailand. A decade of prospective cohort studies has provided important insights into the dengue viruses and their generated disease. However, as elsewhere, spatial dynamics of the pathogen remain poorly understood. In particular, the spatial scale of transmission and the scale of clustering are poorly characterized. This information is critical for effective deployment of spatially targeted interventions and for understanding the mechanisms that drive the dispersal of the virus.

METHODOLOGY/PRINCIPAL FINDINGS: We geocoded the home locations of 4,768 confirmed dengue cases admitted to the main hospital in Kamphaeng Phet …


Elevated Serum Glucose Levels And Survival After Acute Heart Failure: A Population-Based Perspective, Benjamin Helfand, Nicholas Maselli, Darleen Lessard, Jorge Yarzebski, Joel Gore, David Mcmanus, Jane Saczynski, Robert Goldberg Jun 2015

Elevated Serum Glucose Levels And Survival After Acute Heart Failure: A Population-Based Perspective, Benjamin Helfand, Nicholas Maselli, Darleen Lessard, Jorge Yarzebski, Joel Gore, David Mcmanus, Jane Saczynski, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data are available about the characteristics, treatment and survival in patients without diabetes mellitus (DM), previously diagnosed DM and patients with hyperglycaemia who present with acute decompensated heart failure (ADHF). Our objectives were to examine differences in these endpoints in patients hospitalized with ADHF. METHODS: Patients hospitalized with ADHF during 1995, 2000, 2002 and 2004 comprised the study population. RESULTS: A total of 5428 non-diabetic patients were hospitalized with ADHF, 3807 with diagnosed DM and 513 with admission hyperglycaemia. Patients with admission hyperglycaemia experienced the highest in-hospital death rates (9.9%) compared to those with diagnosed DM (6.5%) and …


Assessment Of Obesity As A Cardiovascular Disease Risk Factor In A Geriatric Rural Texas Community - A Six Month Follow-Up, Alberto Coustasse Md, Mba May 2015

Assessment Of Obesity As A Cardiovascular Disease Risk Factor In A Geriatric Rural Texas Community - A Six Month Follow-Up, Alberto Coustasse Md, Mba

Alberto Coustasse, DrPH, MD, MBA, MPH

Coustasse, Alberto, Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community – A Six Month Follow-up. Master of Public Health Track, Public Health Administration, December 1999, 22 pp., 9 tables, 9 illustrations, bibliography, 7 titles. The health fair approach was used as a method to establish individual and population health status baselines and to provide a mechanism to follow-up with an elderly population in a rural Texas community. A controlled trial sample of forty-four seniors was initially screened in a primary care clinic in August 1998. Patients were reevaluated at six months and results …


Leukoaraiosis Predicts Poor 90-Day Outcome After Acute Large Cerebral Artery Occlusion, Nils Henninger, Eugene Lin, Stephen Baker, Ajay Wakhloo, Deepak Takhtani, Majaz Moonis Apr 2015

Leukoaraiosis Predicts Poor 90-Day Outcome After Acute Large Cerebral Artery Occlusion, Nils Henninger, Eugene Lin, Stephen Baker, Ajay Wakhloo, Deepak Takhtani, Majaz Moonis

Nils Henninger

BACKGROUND: To date limited information regarding outcome-modifying factors in patients with acute intracranial large artery occlusion (ILAO) in the anterior circulation is available. Leukoaraiosis (LA) is a common finding among patients with ischemic stroke and has been associated with poor post-stroke outcomes but its association with ILAO remains poorly characterized. This study sought to clarify the contribution of baseline LA and other common risk factors to 90-day outcome (modified Rankin Scale, mRS) after stroke due to acute anterior circulation ILAO. METHODS: We retrospectively analyzed 1,153 consecutive patients with imaging-confirmed ischemic stroke during a 4-year period (2007-2010) at a single academic …


Thirty Day Hospital Re-Admissions In Patients With Non St-Segment Elevation Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Nathaniel Erskine, Jane Saczynski, Jorge Yarzebski, Edgard Granillo, Joel Gore, Robert Goldberg Mar 2015

Thirty Day Hospital Re-Admissions In Patients With Non St-Segment Elevation Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Nathaniel Erskine, Jane Saczynski, Jorge Yarzebski, Edgard Granillo, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data exist about relatively recent trends in the magnitude and characteristics of patients who are rehospitalized shortly after admission for a non ST-segment elevation acute myocardial infarction (NSTEMI). This observational study describes decade-long trends (1999-2009) in the magnitude and characteristics of patients readmitted to the hospital within 30 days of hospitalization for an incident (initial) episode of NSTEMI.

METHODS: We reviewed the medical records of 2,249 residents of the Worcester (MA) metropolitan area who were hospitalized for an initial NSTEMI in 6 biennial periods between 1999 and 2009 at 3 central MA medical centers.

RESULTS: The average age …


Medical Advice And Diabetes Self-Management Reported By Mexican-American, Black- And White-Non-Hispanic Adults Across The United States, Joan A. Vaccaro, Daniel J. Feaster, Sandra L. Lobar, Marianna K. Baum, Marcia Magnus, Fatma G. Huffman Mar 2015

Medical Advice And Diabetes Self-Management Reported By Mexican-American, Black- And White-Non-Hispanic Adults Across The United States, Joan A. Vaccaro, Daniel J. Feaster, Sandra L. Lobar, Marianna K. Baum, Marcia Magnus, Fatma G. Huffman

Joan A. Vaccaro

Background

Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and …


30-Year Trends In Patient Characteristics, Treatment Practices, And Long-Term Outcomes Of Adults Aged 35 To 54 Years Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Joel Gore, Jorge Yarzebski, Andrew Coles, Darleen Lessard, Robert Goldberg Nov 2014

30-Year Trends In Patient Characteristics, Treatment Practices, And Long-Term Outcomes Of Adults Aged 35 To 54 Years Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Joel Gore, Jorge Yarzebski, Andrew Coles, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Much of our knowledge about the characteristics, clinical management, and postdischarge outcomes of acute myocardial infarction (AMI) is derived from clinical studies in middle-aged and older subjects with little contemporary information available about the descriptive epidemiology of AMI in relatively young men and women. The objectives of our population-based study were to describe >3-decade-long trends in the clinical features, treatment practices, and long-term outcomes of young adults aged 35 to 54 years discharged from the hospital after AMI. The study population consisted of 2,142 residents of the Worcester (Massachusetts) metropolitan area who were hospitalized with AMI at all central Massachusetts …


Decade-Long Trends In The Characteristics, Management And Hospital Outcomes Of Diabetic Patients With St-Segment Elevation Myocardial Infarction, Mayra Tisminetzky, Samuel Joffe, David Mcmanus, Chad Darling, Joel Gore, Jorge Yarzebski, Darleen Lessard, Robert Goldberg Nov 2014

Decade-Long Trends In The Characteristics, Management And Hospital Outcomes Of Diabetic Patients With St-Segment Elevation Myocardial Infarction, Mayra Tisminetzky, Samuel Joffe, David Mcmanus, Chad Darling, Joel Gore, Jorge Yarzebski, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

PURPOSE: Our objectives were to describe recent trends in the characteristics and in-hospital outcomes in diabetic as compared with non-diabetic patients hospitalized with ST-segment elevation myocardial infarction (STEMI).

METHODS: We reviewed the medical records of 2537 persons with (n = 684) and without (n = 1853) a history of diabetes who were hospitalized for STEMI between 1997 and 2009 at 11 medical centres in Central Massachusetts.

RESULTS: Diabetic patients were more likely to be older, female and to have a higher prevalence of previously diagnosed comorbidities. Diabetic patients were more likely to have developed important in-hospital complications and to have …


Their Bugs Are Worse Than Their Bite: Emerging Infectious Disease And The Human-Animal Interface, Michael Greger May 2014

Their Bugs Are Worse Than Their Bite: Emerging Infectious Disease And The Human-Animal Interface, Michael Greger

Michael Greger, MD, FACLM

In the twenty-five years since that announcement, what we now know as AIDS has killed 20 million people (National AIDS Trust 2005). Where did the AIDS virus— and other emerging diseases, such as severe acute respiratory syndrome (SARS), Ebola, mad cow— come from?


Weight-Based Discrimination And Medication Adherence Among Low-Income African Americans With Hypertension: How Much Of The Association Is Mediated By Self-Efficacy?, Michael Richardson, Molly Waring, Monica Wang, Lisa Nobel, Yendelela Cuffee, Sharina Person, Sandral Hullett, Catarina Kiefe, Jeroan Allison May 2014

Weight-Based Discrimination And Medication Adherence Among Low-Income African Americans With Hypertension: How Much Of The Association Is Mediated By Self-Efficacy?, Michael Richardson, Molly Waring, Monica Wang, Lisa Nobel, Yendelela Cuffee, Sharina Person, Sandral Hullett, Catarina Kiefe, Jeroan Allison

Monica L. Wang

OBJECTIVES: Much of the excessive morbidity and mortality from cardiovascular disease among African Americans results from low adherence to anti-hypertensive medications. Therefore, we examined the association between weight-based discrimination and medication adherence. METHODS: We used cross-sectional data from low-income African Americans with hypertension. Ordinal logistic regression estimated the odds of medication non-adherence in relation to weight-based discrimination adjusted for age, sex, education, income, and weight. RESULTS: Of all participants (n = 780), the mean (SD) age was 53.7 (9.9) years and the mean (SD) weight was 210.1 (52.8) lbs. Reports of weight-based discrimination were frequent (28.2%). Weight-based discrimination (but not …


The Role Of Multiple Sclerosis As A Risk Factor For The Development Of Osteoporosis, Christopher Perrone, Christine M. Foley, Linda C. Churchill, Sybil L. Crawford, Judith K. Ockene, Carolina Ionete May 2014

The Role Of Multiple Sclerosis As A Risk Factor For The Development Of Osteoporosis, Christopher Perrone, Christine M. Foley, Linda C. Churchill, Sybil L. Crawford, Judith K. Ockene, Carolina Ionete

Sybil L. Crawford

Background: Osteoporosis is the most common bone disease in the United States, and it is particularly common among women with multiple sclerosis (MS). However, despite this association, the temporal relationship between these two conditions has not been previously studied. Data from the Women’s Health Initiative provides a unique opportunity to examine the risk of developing osteoporosis over time in individuals diagnosed with MS. Objective: The purpose of this study is to refine the relationship between MS and osteoporosis, clarifying the impact of environmental and pharmacologic factors on each condition, as well as addressing treatment and preventative efforts for a patient …