Epidemiology Commons^™

Weight Loss Remains A Challenge For Idiopathic Intracranial Hypertension Patients: A Retrospective Case Series From Kenya, Zian Muikamba, Jaskirat Sokhi, Jasmit Shah, Sheila Marco, Juzar Hooker, Dilraj Sokhi

Internal Medicine, East Africa

Background Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by elevated intracranial CSF pressure without demonstratable evident causes. The mechanisms leading to a particular predilection for women of childbearing age who are overweight and obese or who have recent rapid weight changes remain imprecisely described. If undiagnosed, it can progress to disabling irreversible visual loss. Weight loss is useful in addition to medical therapy in treating the condition. There is a rise of obesity in sub-Saharan Africa (SSA) but there is little published on IIH.

Methods We conducted a retrospective cross-sectional study at our tertiary regional referral neurology centre …

Unnoticed Early Pregnancy During Myomectomy With Favorable Outcome: Case Report, Ronak Mulji, Lusajo Mwagobele, Farhat Seif, Zainab Fidaali, Munawar Kaguta

Obstetrics and Gynaecology, East Africa

Introduction

Uterine fibroids are a common cause of infertility, and myomectomy remains a key surgical intervention to improve reproductive outcomes. However, the occurrence of an undetected pregnancy during myomectomy is rare and poses significant clinical risks.

Case Presentation

We report a 34-year-old woman, nulliparous with a history of secondary infertility and three first-trimester miscarriages. She had multiple fibroids and was managed for polycystic ovarian syndrome and hyperprolactinemia. Scheduled for abdominal myomectomy, the surgery proceeded uneventfully, with six fibroids removed and no breach of the endometrial cavity. Five weeks postoperatively, she presented with symptoms suggestive of early pregnancy. Ultrasound confirmed a …

Cervical Hpv 18 Detection Is Associated With High-Grade Cervical Dysplasia In Kenyan And Ugandan Women Living With Hiv, Miriam Nakalembe, Collins Mpamani, Jane Namugga, Carolyn Nakisige, Grace Banturaki, Phillip Tonui, Peter Itsura, Omenge Orango, Kapten Muthoka, Anthony Ngeresa

Obstetrics and Gynaecology, East Africa

Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical …

Cervical Hpv 18 Detection Is Associated With High-Grade Cervical Dysplasia In Kenyan And Ugandan Women Living With Hiv, Miriam Nakalembe, Collins Mpamani, Jane Namugga, Carolyn Nakisige, Grace Banturaki, Phillip Tonui, Peter Itsura, Elkanah Orang'o, Kapten Muthoka, Anthony Ngeresa

Obstetrics and Gynaecology, East Africa

Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical …

Growth Measurements In Ugandan Children With Sickle Cell Anaemia From A Hydroxyurea (Hydroxycarbamide) Treatment Trial Relative To Unaffected Sibling Controls, Dennis Kalibbala, Vincent Mboizi, Grace Nambatya, Susan Murungi, Joan Ashaba, Catherine Nabaggala, Lynnth Turyagyenda, Deogratias Munube, Phillip Kasirye, Robert Opoka

Paediatrics and Child Health, East Africa

No abstract provided.

Prevalence And Risk Factors Of Hypertension Among Clients Seeking Care At Selected Healthcare Facilities In Kenya, Jasmit Shah, Soraiya Manji, Jamila Nambafu, Cynthia Smith, Anthony Ochola, Linda Barasa, Faraj Amir, Husni Abdalla, Rajiv Patel, Sayed Karar

Internal Medicine, East Africa

Background Hypertension remains one of the primary risk factors for cardiovascular disease and the leading cause of mortality worldwide. According to the World Health Organization (WHO), as estimated 1.28 billion adults suffer from hypertension worldwide and approximately half are unaware of the problem. This study aimed to explore the prevalence of hypertension, and the association of sociodemographic, behavioral, and physiological factors related to hypertension in patients seeking care at the different healthcare facilities in Kenya.

Methodology We carried out a cross-sectional survey study between April 2023 and July 2023. The general adult public visiting the outpatient clinics were recruited from …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: Diabetes mellitus is the 7^th leading cause of death in the United States and is 6^th in the state of Texas. Counties from South Texas are primarily affected with higher rates of diabetes than both the state and national average. Diabetes mellitus is a complex and progressive disease which can affect multiple systems of the body, leading to serious complications if untreated, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas is a region predominantly populated by Hispanic Americans who are disproportionally …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Diabetes mellitus is the 7th leading cause of death in the U.S. and 6th in Texas. South Texas counties have higher diabetes rates than state and national averages. This complex, progressive disease affects multiple body systems and can lead to serious complications, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas, predominantly Hispanic American, is disproportionately affected. This demographic faces clinical barriers due to a lack of cultural understanding, highlighting the need for culturally sensitive healthcare workers such as promotoras. This study aimed to …

Unravelling The Distinct Effects Of Vhl Mutations And Chromosome 3p Loss In Clear Cell Renal Cell Carcinoma: Implications For Prognosis And Treatment, Xiang Wang, Jian-Rong Li, Naail Raed Chowdhury, Lang Wu, Cheng Chao

Faculty, Staff and Students Publications

No abstract provided.

Documentation And Referral Of Social Determinants Of Health In New Mexico’S Emergency Departments: International Classification Of Disease, Tenth Revision, Clinical Modification, “Z Codes” (Z55-Z65), Samuel L. Swift, Maya Stefanovic, Roselyn Thalathara

Population Health Research and Scholarship

No abstract provided.

Htlv-1 And Atll: Epidemiology, Oncogenesis, And Opportunities For Community-Informed Research In The United States, Adrian D. Altieri, Sean P. Reilly, Abu Mansalay, Alan Khoo, Nettie Johnson, Zafar K. Khan, Amy Leader, Pooja Jain, Pierluigi Porcu

Kimmel Cancer Center Faculty Papers

Human T-cell leukemia virus type 1 (HTLV-1), the first oncogenic human retrovirus, causes adult T-cell leukemia/lymphoma (ATLL), an aggressive neoplasm of mature CD4+ T-cells that is incurable in most patients and is associated with a median survival of less than 1 year. HTLV-1 also causes inflammatory disorders, including HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and uveitis. The estimated lifetime risks of ATLL and HAM/TSP in HTLV-1 carriers are 3-5% and 0.25-1.8%, respectively. Although there is uncertainty about other health effects of HTLV-1, a recent meta-analysis showed an association between HTLV-1 and cardiovascular, cerebrovascular, and metabolic diseases and a 57% increased risk …

Glucodensity Functional Profiles Outperform Traditional Continuous Glucose Monitoring Metrics, Marcos Matabuena, Rahul Ghosal Ph.D., Javier Enrique Aguilar, Ayya Keshet, Robert Wagner, Carmen Fernández Merino, Juan Sánchez Castro, Vadim Zipunnikov, Jukka-Pekka Onnela, Francisco Gude

Faculty Publications

Continuous glucose monitoring (CGM) data have revolutionized the management of type 1 diabetes, particularly when integrated with insulin pumps to mitigate clinical events such as hypoglycemia. Recently, there has been growing interest in utilizing CGM devices in clinical studies involving healthy and diabetic populations. However, efficiently exploiting the high temporal resolution of CGM profiles remains a significant challenge. Numerous indices—such as time–in–range metrics and glucose variability measures–have been proposed, but evidence suggests these metrics overlook critical aspects of dynamic glucose homeostasis. As an alternative method, this paper explores the clinical value of glucodensity metrics in capturing glucose dynamics—specifically the speed …

Opportunities And Barriers To Engaging Caregivers In Firearm Suicide Prevention: Findings From Focus Groups With Caregivers Of Veterans, Katherine Macwilliams, John Marmion, Dee Blascyk, Sharon Urbina, Rachel Moyers, Gala True

School of Medicine Faculty Publications

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers’ experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans. Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis. Results: We identified three primary themes: 1) caregivers recognize …

Global, Regional, And National Burden Of Cardiovascular Diseases And Risk Factors In 204 Countries And Territories, 1990-2023, Global Burden Of Cardiovascular Diseases And Risks 2023 Collaborators, Mohammadreza Abbasian

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging.

OBJECTIVES: We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure.

METHODS: The Global Burden of Disease (GBD) 2023 study, a multinational …

Trends And Disparities In Acute Coronary Syndrome-Related Mortality In The United States: Implications For Healthcare, Muhammad Khuzzaim Khan, Ibrahim Ahmed Khan, Abdul Moiz Javed, Arslan Wazir, Hira Saleem, Muhammad Zohaib, Faisal Rasheed, Priyanka Mohan Lal, Syeda Laiba Sherazi, Amiaz Karim, Nikhil Duseja, Hussam Al Hennawi

Abington Jefferson Health Papers

Acute coronary syndrome (ACS) is a major cause of morbidity and mortality in the United States (US). However, the trends and disparities in ACS mortality are not well understood. This study aimed to analyze the ACS mortality in the US from 1999 to 2020 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. The age-adjusted mortality rates (AAMR) due to ACS were calculated for each year from 1999 to 2020, stratified by sex, race, urbanization, and state. The trends and disparities in AAMR were examined using descriptive statistics and graphical methods. The AAMR due …

Two Essays On Health And Health Behavior In China, Jiamin Tan

Lingnan Theses (MPhil & PhD)

This thesis consists of two empirical studies on elderly mental health and on health behaviors. The first study investigates the long-term impact of childhood hunger on mental health in later life, using data from two nationally representative surveys in China. The study finds that childhood hunger exposure significantly increases the risks of depression and anxiety in later life. These effects are most pronounced among individuals exposed after age 5, suggesting that autobiographical memory formation plays an important role beyond socioeconomic and health pathways. The findings further indicate these impacts can be mitigated through economic interventions, such as welfare programs, and …

A Case Study Of Long-Term Disease Burden In A Rural Community Near An Open Burn Facility, Arundhati Bakshi, Liana Baconguis, Md Abdullah Al-Mamun, Qingzhao Yu, Jennifer Richmond-Bryant, Stephania A. Cormier

School of Public Health Faculty Publications

Open burning and open detonation (OB/OD) of explosive and hazardous wastes creates various toxic waste products, including particulate matter, that is released into the atmosphere and capable of generating significant health impacts upon exposure. The last commercially run OB/OD thermal treatment facility in operation in the United States is located near the rural community of Colfax in central Louisiana. To evaluate the community’s concerns about the potential health impacts from air pollution due to the facility’s regular open burning of explosive and hazardous wastes, we examined the disease burden in Colfax compared to the surrounding parish and state. In a …

Allosteric Control Overcomes Steric Limitations For Neutralizing Antibodies Targeting Conserved Binding Epitopes Of The Sars-Cov-2 Spike Protein: Exploring The Intersection Of Binding, Allostery, And Immune Escape With A Multimodal Computational Approach, Mohammed Alshahrani, Vedant Parikh, Brandon Foley, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

Understanding the atomistic basis of multi-layer mechanisms employed by broadly reactive neutralizing antibodies of the SARS-CoV-2 spike protein without directly blocking receptor engagement remains an important challenge in coronavirus immunology. Class 4 antibodies represent an intriguing case: they target a deeply conserved, cryptic epitope on the receptor-binding domain yet exhibit variable neutralization potency across subgroups F1 (CR3022, EY6A, COVA1-16), F2 (DH1047), and F3 (S2X259). The molecular basis for this variability is not fully understood. Here, we employed a multi-modal computational approach integrating atomistic and coarse-grained molecular dynamics simulations, binding free energy calculations, mutational scanning, and dynamic network analysis to elucidate …

Obesity Severity And Cancer Screening In Us Adults, Florina Corpodean, Michael Kachmar, Shengping Yang, Michael W. Cook, Philip R. Schauer, Vance L. Albaugh

School of Medicine Faculty Publications

No abstract provided.

Effect Of Vitamin D Supplementation During Pregnancy And Lactation On The Development Of Infants Born To Tanzanian Women Living With Hiv: A Secondary Analysis Of A Randomised Controlled Trial, Temiwunmi Shobanke, Alfa Muhihi, Nandita Perumal Phd, Nzovu Ulenga, Fadhlun M. Alwy Al-Beity, Christopher P. Duggan, Wafaie W. Fawzi, Karim P. Manji, Christopher R. Sudfeld

Faculty Publications

Background Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes.

Objectives This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes.

Design We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019.

Setting Antenatal care clinics in Dar es Salaam, Tanzania.

Participants Pregnant WLHIV and their offspring.

Interventions Daily 3000 IU …