Epidemiology Commons^™

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

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) …

A Delphi Process To Address Medication Appropriateness For Older Persons With Multiple Chronic Conditions, Terri R. Fried, Kristina Niehoff, Jennifer Tjia, Nancy Redeker, Mary K. Goldstein

Jennifer Tjia

BACKGROUND: Frameworks exist to evaluate the appropriateness of medication regimens for older patients with multiple medical conditions (MCCs). Less is known about how to translate the concepts of the frameworks into specific strategies to identify and remediate inappropriate regimens.

METHODS: Modified Delphi method involving iterative rounds of input from panel members. Panelists (n = 9) represented the disciplines of nursing, medicine and pharmacy. Included among the physicians were two geriatricians, one general internist, one family practitioner, one cardiologist and two nephrologists. They participated in 3 rounds of web-based anonymous surveys.

RESULTS: The panel reached consensus on a set of markers …

Correlates Of Hiv Acquisition In A Cohort Of Black Men Who Have Sex With Men In The United States: Hiv Prevention Trials Network (Hptn) 061, Beryl A. Koblin, Kenneth H. Mayer, Susan H. Eshleman, Lei Wang, Sharon B. Mannheimer, Carlos Del Rio, Steve Shoptaw, Manya Magnus, Susan Buchbinder, Leo Wilton, Ting-Yuan Liu, Vanessa Cummings, Estelle Piwowar-Manning, Sheldon D. Fields, Sam Griffith, Vanessa Elharrar, Darrell Wheeler

Leo Wilton

Background

Black men who have sex with men (MSM) in the United States (US) are affected by HIV at disproportionate rates compared to MSM of other race/ethnicities. Current HIV incidence estimates in this group are needed to appropriately target prevention efforts.

Methods

From July 2009 to October 2010, Black MSM reporting unprotected anal intercourse with a man in the past six months were enrolled and followed for one year in six US cities for a feasibility study of a multi-component intervention to reduce HIV infection. HIV incidence based on HIV seroconversion was calculated as number of events/100 person-years. Multivariate proportional …

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

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

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

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

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 …

Introduction To Targeted Learning, Laura Balzer

Laura B. Balzer

No abstract provided.

Early Diagnosis Of Dengue Disease Severity In A Resource-Limited Asian Country, Philippe Cavailler, Arnaud Tarantola, Yee Sin Leo, Andrew A. Lover, Anne Rachline, Duch Moniboth, Rekol Huy, Ai Li Quake, Kdan Yuvatha, Veasna Duong, Jeremy L. Brett, Philippe Buchy

Andrew Lover

Eliminate Now: Seven Critical Actions Required To Accelerate Elimination Of Plasmodium Falciparum Malaria In The Greater Mekong Subregion, Andrew A. Lover, Roly Gosling, Richard Feachem, Jim Tulloch

Andrew Lover

Serological Evidence For Localized And Persistent Antibody Response In Zika Virus-Positive Neonates With Microcephaly (Brazil, 2015)- A Secondary Analysis, Andrew A. Lover

Andrew Lover