Clinical Epidemiology Commons^™

Preparedness Of Hospitals In The Republic Of Ireland For An Influenza Pandemic, An Infection Control Perspective, Mary Reidy, Fiona Ryan, Dervla Hogan, Seán Lacey, Claire Buckley

Department of Mathematics Publications

When an influenza pandemic occurs most of the population is susceptible and attack rates can range as high as 40–50 %. The most important failure in pandemic planning is the lack of standards or guidelines regarding what it means to be ‘prepared’. The aim of this study was to assess the preparedness of acute hospitals in the Republic of Ireland for an influenza pandemic from an infection control perspective.

Adolescent Exercise In Association With Mortality From All Causes, Cardiovascular Disease, And Cancer Among Middle-Aged And Older Chinese Women, Sarah J. Nechuta, Xiao Ou Shu, Gong Yang, Hui Cai, Yu-Tang Gao, Hong-Lan Li, Yong-Bing Xiang, Wei Zheng

Peer Reviewed Articles

Background: Little is known regarding the role of early-life exercise, a potentially modifiable factor, in long-term adult morbidity and mortality. We utilized the Shanghai Women's Health Study (SWHS) to investigate adolescent exercise in association with cancer, cardiovascular disease (CVD), and all-cause mortality among middle-aged and older women.

Methods: The SWHS is a prospective cohort of 74,941 Chinese women ages 40 to 70 years recruited from 1996 to 2000. In-person interviews at enrollment assessed adolescent and adult exercise history, medical and reproductive history, and other lifestyle and socioeconomic (SES) factors. Mortality follow-up occurs via annual linkage to the Shanghai Vital Statistics …

Mesothelioma Patients With Germline Bap1 Mutations Have 7-Fold Improved Long-Term Survival, F. Baumann, E. Flores, A. Napolitano, S. Kanodia, E. Taioli, H. Pass, H. Yang, M. Carbone

Journal Articles

BRCA1-associated protein-1 (BAP1) mutations cause a new cancer syndrome, with a high rate of malignant mesothelioma (MM). Here, we tested the hypothesis that MM associated with germline BAP1 mutations has a better prognosis compared with sporadic MM. We compared survival among germline BAP1 mutation MM patients with that of all MM (N = 10 556) recorded in the United States Surveillance, Epidemiology, and End Results (SEER) data from 1973 to 2010. We identified 23 MM patients-11 alive-with germline BAP1 mutations and available data on survival. Ten patients had peritoneal MM, ten pleural MM and three MM in both locations. Thirteen …

The Glass Is Half Full: Evidence For Efficacy Of Alcohol-Wise At One University But Not The Other, K. Croom, L. Staiano-Coico, M. Lesser, D. K. Lewis, V. F. Reyna, T. C. Marchell, J. Frank, S. Ives

Journal Articles

This research extends the growing literature about online alcohol prevention programs for first-year college students. Two independent randomized control studies, conducted at separate universities, evaluated the short-term effectiveness of Alcohol-Wise, an online alcohol prevention program not previously studied. It was hypothesized the prevention program would increase alcohol knowledge and reduce alcohol consumption, including high-risk alcohol-related behaviors, among first-year college students. At both universities, the intervention significantly increased alcohol-related knowledge. At one university, the prevention program also significantly reduced alcohol consumption and high-risk drinking behaviors, such as playing drinking games, heavy drinking, and extreme ritualistic alcohol consumption. Implications for the use …

Circulating Adipokines And Inflammatory Markers And Postmenopausal Breast Cancer Risk, M. J. Gunter, T. Wang, M. Cushman, X. Xue, S. Wassertheil-Smoller, H. D. Strickler, T. E. Rohan, J. E. Manson, A. Mctiernan, G. Y. Ho, +5 Additional Authors

Journal Articles

BACKGROUND: Adipokines and inflammation may provide a mechanistic link between obesity and postmenopausal breast cancer, yet epidemiologic data on their associations with breast cancer risk are limited. METHODS: In a case-cohort analysis nested within the Women's Health Initiative Observational Study, a prospective cohort of postmenopausal women, baseline plasma samples from 875 incident breast cancer case patients and 839 subcohort participants were tested for levels of seven adipokines, namely leptin, adiponectin, resistin, interleukin-6, tumor necrosis factor-alpha, hepatocyte growth factor, and plasminogen activator inhibitor-1, and for C-reactive protein (CRP), an inflammatory marker. Data were analyzed by multivariable Cox modeling that included established …

Heart Failure: An Exploration Of Recent Advances In Research And Treatment (A), A. Szema, A. Mclarty, H. Skopicki, M. Bloom, R. Jermyn

Journal Articles

No abstract provided.

Emerging Novel Therapies For Heart Failure, A. M. Szema, S. Dang, J. C. Li

Journal Articles

No abstract provided.

Metformin And Myocardial Injury In Patients With Diabetes And St-Segment Elevation Myocardial Infarction: A Propensity Score Matched Analysis, S. Basnet, A. Kozikowski, A. N. Makaryus, R. Pekmezaris, R. Zeltser, M. Akerman, M. Lesser, G. Wolf-Klein

Journal Articles

No abstract provided.

Tlr7 Influences Germinal Center Selection In Murine Sle, A. Boneparth, W. Huang, R. Bethunaickan, M. Woods, R. Sahu, S. Arora, M. Akerman, M. Lesser, A. Davidson

Journal Articles

TLR7 enhances germinal center maturation and migration of B cells to the dark zone where proliferation and somatic hypermutation occur. Our goal was to determine how Tlr7 dose influences selection of the autoreactive B cell repertoire in NZW/BXSB. Yaa mice bearing the site-directed heavy chain transgene 3H9 that encodes for the TLR7 regulated anti-CL response. To create a physiologic setting in which autoreactive B cells compete for survival with non-autoreactive B cells, we generated bone marrow chimeras in which disease onset occurred with similar kinetics and the transferred 3H9+ female non-Yaa, male Yaa or male TLR7(-/Yaa) cells could be easily …

Effectiveness Of Fecal-Derived Microbiota Transfer Using Orally Administered Capsules For Recurrent Clostridium Difficile Infection, B. E. Hirsch, N. Saraiya, K. Poeth, R. M. Schwartz, M. E. Epstein, G. Honig

Journal Articles

BACKGROUND: Clostridium difficile infection (CDI), a complication of antibiotic-induced injury to the gut microbiome, is a prevalent and dangerous cause of infectious diarrhea. Antimicrobial therapy for CDI is typically effective for acute symptoms, but up to one third of patients later experience recurrent CDI. Fecal-derived microbiota transplantation (FMT) can ameliorate the underlying dysbiosis and is highly effective for recurrent CDI. Traditional methods of FMT are limited by patient discomfort, risk and inefficient procedures. Many individuals with recurrent CDI have extensive comorbidities and advanced age. Widespread use of FMT requires strategies that are non-invasive, scalable and applicable across healthcare settings. METHODS: …

Seasonal Variations Of Complete Blood Count And Inflammatory Biomarkers In The Us Population - Analysis Of Nhanes Data, B. Liu, E. Taioli

Journal Articles

BACKGROUND: Recent studies reported seasonal differences in gene expression in white blood cells, adipose tissue, and inflammatory biomarkers of the immune system. There is no data on the seasonal variations of these biomarkers in the US general population of both children and adults. Then aim of this study is to explore the seasonal trends in complete blood count (CBC), and C-reactive protein (CRP) in a large non-institutionalized US population. METHODS: Seven cross-sectional data collected in the National Health and Nutrition Examination Survey (NHANES) during 1999-2012 were aggregated; participants reporting recent use of prescribed steroids, chemotherapy, immunomodulators and antibiotics were excluded. …

Determinants Of Survival In Malignant Pleural Mesothelioma: A Surveillance, Epidemiology, And End Results (Seer) Study Of 14,228 Patients, E. Taioli, A. S. Wolf, M. Camacho-Rivera, A. Kaufman, D. S. Lee, D. Nicastri, K. Rosenzweig, R. M. Flores

Journal Articles

INTRODUCTION: Left untreated, malignant pleural mesothelioma (MPM) is associated with uniformly poor prognosis. Better survival has been reported with surgery-based multimodality therapy, but to date, no trial has demonstrated survival benefit of surgery over other therapies. We evaluated whether cancer-directed surgery influenced survival independently from other predictors in a large population-based dataset. METHODS: The SEER database was explored from 1973 to 2009 to identify all cases of pathologically-proven MPM. Age, sex, race, year of diagnosis, histology stage, cancer-directed surgery, radiation, and vital status were analyzed. The association between prognostic factors and survival was estimated using Cox regression and propensity matched …

Frequency Of Surgery In Black Patients With Malignant Pleural Mesothelioma, E. Taioli, A. S. Wolf, J. Moline, M. Camacho-Rivera, R. M. Flores

Journal Articles

Introduction. Malignant Pleural Mesothelioma (MPM) is a rare disease, even less frequently described in minority patients. We used a large population-based dataset to study the role of race in MPM presentation, treatment, and survival. Methods. All cases of pathologically proven MPM were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Age, sex, diagnosis year, stage, cancer-directed surgery, radiation, and vital status were analyzed according to self-reported race (black or white). Results. There were 13,046 white and 688 black MPM patients (incidence: 1.1 per 100,000 whites; 0.5 per 100,000 blacks; age-adjusted,P = 0.01). Black patients were more likely to …

Breast Cancer Risk In Metabolically Healthy But Overweight Postmenopausal Women, M. J. Gunter, X. Xie, X. Xue, G. C. Kabat, T. E. Rohan, S. Wassertheil-Smoller, G. Y. Ho, J. Wylie-Rosett, J. Beasley, H. D. Strickler, +2 Additional Authors

Journal Articles

Adiposity is an established risk factor for postmenopausal breast cancer. Recent data suggest that high insulin levels in overweight women may play a major role in this relationship, due to insulin's mitogenic/antiapoptotic activity. However, whether overweight women who are metabolically healthy (i.e., normal insulin sensitivity) have elevated risk of breast cancer is unknown. We investigated whether overweight women with normal insulin sensitivity [i.e., homeostasis model assessment of insulin resistance (HOMA-IR) index, or fasting insulin level, within the lowest quartile (q1)] have increased breast cancer risk. Subjects were incident breast cancer cases (N = 497) and a subcohort (N = 2,830) …

Differential Expression Of Circulating Micrornas According To Severity Of Colorectal Neoplasia, G. Y. Ho, H. J. Jung, R. E. Schoen, T. Wang, J. Lin, Z. Williams, J. L. Weissfeld, J. Y. Park, O. Loudig, Y. Suh

Journal Articles

There is a need to develop a colorectal cancer (CRC) screening test that is noninvasive, cost effective, and sensitive enough to detect preneoplastic lesions. This case-control study examined the feasibility of using circulating extracellular microRNAs (miRNAs) to differentiate a spectrum of colorectal neoplasia of various severity and hence for early detection of colorectal neoplasia. Archived serum samples of 10 normal controls and 31 cases, including 10 with nonadvanced adenoma, 10 with advanced adenoma, and 11 with CRC, were profiled for circulating miRNAs using next-generation sequencing. Multiple linear regression, adjusting for age, gender, and smoking status, compared controls and the 3 …

Oral Bisphosphonate Use And Risk Of Postmenopausal Endometrial Cancer, P. A. Newcomb, M. N. Passarelli, A. I. Phipps, G. L. Anderson, J. Wactawski-Wende, G. Y. Ho, M. J. O'Sullivan, R. T. Chlebowski

Journal Articles

PURPOSE: Bisphosphonates are common medications used for the treatment of osteoporosis and are also used to reduce metastases to bone in patients with cancer. Several studies, including the Women's Health Initiative (WHI), have found that use of bisphosphonates is associated with reduced risk of developing breast cancer, but less is known about associations with other common malignancies. This study was aimed at examining the effects of bisphosphonates on the risk of endometrial cancer. METHODS: We evaluated the relationship between use of oral bisphosphonates and endometrial cancer risk in a cohort of 89,918 postmenopausal women participating in the WHI. A detailed …

"Nursing Contamination: Wearing Scrubs In Public", Kemble Green

Undergraduate Honors Theses

Nurses are frequently seen in public in their “scrubs,” which could mean that contaminated clothing is being brought into the community, thereby posing an infection risk. The purpose of this study is to investigate if and which contaminants are present on the fabrics and the actions nurses are taking to eliminate contamination risks.

Eleven scrub tops were worn on hospital units over one twelve-hour shift. The contaminated scrubs and three control tops were then swabbed and used to inoculate agar plates. After incubation, colonies were counted, streaked onto nutrient and Mannitol-salt agar for isolation, and incubated. Using API Staph strips …

Perceptions Of Neighborhood Safety And Asthma Among Children And Adolescents In Los Angeles: A Multilevel Analysis, M. Camacho-Rivera, I. Kawachi, G. G. Bennett, S. V. Subramanian

Journal Articles

Background: Research examining the impact of neighborhoods on asthma has shown an increased interest in the role of the psychosocial environment. We examined the associations between various measures of neighborhood safety, individual and family characteristics, and asthma outcomes among children in Los Angeles. Methods: Multilevel logistic regression models were used to analyze data on 3,114 children across 65 neighborhoods from Wave 1 of the Los Angeles Family and Neighborhood Survey (2000 to 2002). Primary caregivers reported asthma outcome and all individual covariates; home environmental characteristics were observed by the interviewer. Results: In fully adjusted models, parents who reported their neighborhood …

Associations Between Human Papillomavirus And History Of Cancer Among Us Adults In The National Health And Nutrition Examination Survey (2003-2010), B. Liu, E. Taioli

Journal Articles

Background: Human papillomavirus (HPV) is an infectious agent that has been associated with human cancer. We have updated the U.S. population sero-prevalence using a large National Health and Nutrition Examination Survey (NHANES) sample of adults from 2003 to 2010, and have analysed the associations between HPV seropositivity and self-reported history of cancer. Methods: Four cross-sectional cycles (2003-2004, 2005-2006, 2007-2008, and 2009-2010) were used, for a total of 12 759 participants who had both cancer history and HPV serum information. Results: The sero-prevalences of HPV types 6, 11, 16, and 18 were 15.0%, 4.8%, 11.5%, and 4.1%, respectively. Females had significantly …

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder Among Responders And Civilians: A Meta-Analysis, B. Liu, L. H. Tarigan, E. J. Bromet, H. Kim

Journal Articles

The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e. …

Revisiting The Hispanic Health Paradox: The Relative Contributions Of Nativity, Country Of Origin, And Race/Ethnicity To Childhood Asthma, M. Camacho-Rivera, I. Kawachi, G. G. Bennett, S. V. Subramanian

Journal Articles

This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9 % of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also …

Average Values And Racial Differences Of Neutrophil Lymphocyte Ratio Among A Nationally Representative Sample Of United States Subjects, B. Azab, M. Camacho-Rivera, E. Taioli

Journal Articles

Introduction: Several studies reported the negative impact of elevated neutrophil/lymphocyte ratio (NLR) on outcomes in many surgical and medical conditions. Previous studies used arbitrary NLR cut-off points according to the average of the populations under study. There is no data on the average NLR in the general population. The aim of this study is to explore the average values of NLR and according to race in adult non-institutional United States individuals by using national data. Methods: The National Health and Nutrition Examination Survey (NHANES) of aggregated cross-sectional data collected from 2007 to 2010 was analyzed; data extracted included markers of …

Distribution Of Human Papillomavirus Genotypes Among Hiv-Positive And Hiv-Negative Women In Cape Town, South Africa, A. C. Mcdonald, A. I. Tergas, L. Kuhn, L. Denny, T. C. Wright Jr.

Journal Articles

OBJECTIVE: HIV-positive women are known to be at high-risk of human papillomavirus (HPV) infection and its associated cervical pathology. Here, we describe the prevalence and distribution of HPV genotypes among HIV-positive and -negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN). METHODS: We report data on 1,371 HIV-positive women and 8,050 HIV-negative women, aged 17-65 years, recruited into three sequential studies in Cape Town, South Africa, conducted among women who had no history of cervical cancer screening recruited from the general population. All women were tested for HIV. Cervical samples were tested for high-risk HPV DNA (Hybrid …

Association Between Systemic Inflammatory Markers And Serum Prostate-Specific Antigen In Men Without Prostatic Disease-The 2001-2008 National Health And Nutrition Examination Survey, A. C. Mcdonald, M. A. Vira, A. C. Vidal, W. Q. Gan, S. J. Freedland, E. Taioli

Journal Articles

No abstract provided.

Incidence Of Extended-Spectrum-Beta-Lactamase-Producing Escherichia Coli And Klebsiella Pneumoniae Isolates That Test Susceptible To Cephalosporins And Aztreonam By The Revised Clsi Breakpoints, C. S. Mcwilliams, S. Condon, R. M. Schwartz, C. C. Ginocchio

Journal Articles

The incidence of aztreonam and cephalosporin susceptibility, determined using the revised CLSI breakpoints, for extendedspectrum-beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates was evaluated. Our analysis showed that results for aztreonam and/or> 1 cephalosporin were reported as susceptible or intermediate for 89.2% of ESBLproducing E coli isolates (569/638 isolates) and 67.7% of ESBL-producing K. pneumoniae isolates (155/229 isolates).

Do Hiv-Positive Women Receive Depression Treatment That Meets Best Practice Guidelines?, J. A. Cook, J. K. Burke-Miller, D. D. Grey, J. Cocohoba, C. L. Liu, R. M. Schwartz, E. T. Golub, K. Anastos, P. J. Steigman, M. H. Cohen

Journal Articles

This study addressed whether psychopharmacologic and psychotherapeutic treatment of depressed HIV+ women met standards defined in the best practice literature, and tested hypothesized predictors of standard-concordant care. 1,352 HIV-positive women in the multi-center Women's Interagency HIV Study were queried about depressive symptoms and mental health service utilization using standards published by the American Psychiatric Association and the Agency for Healthcare Research and Quality to define adequate depression treatment. We identified those who: (1) reported clinically significant depressive symptoms (CSDS) using Centers for Epidemiological Studies-Depression Scale scores of a parts per thousand yen16; or (2) had lifetime diagnoses of major depressive …

Comparative Definitions For Moderate-Severe Ischemia In Stress Nuclear, Echocardiography, And Magnetic Resonance Imaging, L. J. Shaw, D. S. Berman, M. H. Picard, G. W. Stone, R. Senior, J. K. Min, R. Hachamovitch, M. Scherrer-Crosbie, J. H. Mieres, P. S. Douglas, +19 Additional Authors

Journal Articles

The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with >= 10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. A narrative review revealed that >= 10% ischemic myocardium on stress nuclear imaging was associated with a median rate of CAD death or MI of 4.9%/year (interquartile range: 3.75% to 5.3%). For stress echocardiography, >= 3 newly dysfunctional segments …

Knowledge And Prevention Practices Before Breast Cancer Diagnosis In A Cross-Sectional Study Among Survivors: Impact On Patients' Involvement In The Decision Making Process, E. Taioli, G. R. Joseph, L. Robertson, S. Eckstein, C. Ragin

Journal Articles

Disparities exist in breast cancer knowledge and education, which tend to influence symptom interpretation and decision to seek screening/care. The present project describes a cohort of women's experiences, knowledge, and health behavior prior to and after a diagnosis of breast cancer. It also studies how knowledge and demographic factors are associated with level of involvement participants had in the treatment of their breast cancer. Women > 18 years who have been diagnosed and treated for breast cancer within 10 years were recruited in Pittsburgh, PA, through the Healthy People Cohort Registry, a database of volunteers from the community, and Brooklyn, NY, …

Long-Term Exposure To Traffic-Related Air Pollution And Progression Of Carotid Artery Atherosclerosis: A Prospective Cohort Study, W. Q. Gan, R. W. Allen, M. Brauer, H. W. Davies, G. B. J. Mancini, S. A. Lear

Journal Articles

Objectives Epidemiological studies have demonstrated associations between long-term exposure to traffic-related air pollution and coronary heart disease (CHD). Atherosclerosis is the principal pathological process responsible for CHD events, but effects of traffic-related air pollution on progression of atherosclerosis are not clear. This study aimed to investigate associations between long-term exposure to traffic-related air pollution and progression of carotid artery atherosclerosis. Setting Healthy volunteers in metropolitan Vancouver, Canada. Participants and outcome measures 509 participants aged 30-65years were recruited and followed for approximately 5years. At baseline and end of follow-up, participants underwent carotid artery ultrasound examinations to assess atherosclerosis severity, including carotid …

Psychosocial Correlates Of Gender-Based Violence Among Hiv-Infected And Hiv-Uninfected Women In Three Us Cities, R. M. Schwartz, K. M. Weber, G. E. Schechter, N. C. Connors, Y. Gousse, M. A. Young, M. H. Cohen

Journal Articles

Gender-based violence (GBV) is common among women with and at risk for HIV, yet little is known about the GBV associated psychological factors that could be modifiable through behavioral interventions. The current study examined the associations between some of these psychological factors (i.e., hopelessness, consideration of future consequences, self esteem), mental health symptoms, substance abuse, and GBV among a sample of 736 HIV-infected and sociodemographically similar uninfected participants in the Women's Interagency HIV Study (WIHS). Results indicated high rates of lifetime GBV among the sample (58%), as well as high rates of childhood sexual abuse (CSA) (22.2%). HIV-infected women were …