scholarly journals Ethnic Disparities in Coronavirus Disease 2019 after the Implementation of Universal Screening in Hartford, Connecticut

2021 ◽  
Vol 11 (04) ◽  
pp. e147-e153
Author(s):  
Veronica Maria Pimentel ◽  
Frank Ian Jackson ◽  
Anthony Dino Ferrante ◽  
Reinaldo Figueroa
Keyword(s):  
Pregnancy Outcomes ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Universal Screening ◽  
Ethnic Disparities ◽  
Factors Associated ◽  
Key Points ◽  
Delivery Unit ◽  
Baseline Characteristics ◽  
Racial Ethnic

Objective The aim of this article was to estimate the prevalence of coronavirus disease 2019 (COVID-19) in Connecticut, examine racial/ethnic disparities, and assess pregnancy outcomes in pregnant women following the implementation of universal screening for the virus. Materials and methods This is a retrospective cohort study of all obstetric patients admitted to our labor and delivery unit during the first 4 weeks of implementation of universal screening of COVID-19. Viral studies were performed in all neonates born to mothers with severe acute respiratory syndrome coronavirus 2. We calculated the prevalence of COVID-19, compared the baseline characteristics and pregnancy outcomes between those who tested positive and negative for the virus, and determined the factors associated with COVID-19. Results A total of 10 (4.6%) of 220 women screened positive for the virus. All were asymptomatic. Week 1 had the highest prevalence of infection, nearing 8%. No neonates were infected. Hispanics were more likely to test positive (odds ratio: 10.23; confidence interval: [2.71–49.1], p = 0.001). Obstetric and neonatal outcomes were similar between the groups (p > 0.05). Conclusion Although the rate of asymptomatic COVID-19 was low, ethnic disparities were present with Hispanics being more likely to have the infection. Key Points

scholarly journals Racial-ethnic disparities and pregnancy outcomes in SARS-CoV-2 infection in a universally-tested cohort in Houston, Texas

2020 ◽  
Vol 254 ◽  
pp. 329-330
Author(s):  
Beth L. Pineles ◽  
Isabella Ciuffetelli Alamo ◽  
Nihan Farooq ◽  
Jessica Green ◽  
Sean C. Blackwell ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Ethnic Disparities ◽  
Racial Ethnic

scholarly journals Clinical Characteristics and Predictors of Outcomes of Hospitalized Patients With Coronavirus Disease 2019 in a Multiethnic London National Health Service Trust: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Pablo N Perez-Guzman ◽  
Anna Daunt ◽  
Sujit Mukherjee ◽  
Peter Crook ◽  
Roberta Forlano ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Severe Renal Impairment ◽  
Severe Hypoxemia ◽  
Factors Associated ◽  
National Health Service Trust ◽  
Black Patients ◽  
Predictors Of Outcomes ◽  
Minority Ethnic

Abstract Background Emerging evidence suggests ethnic minorities are disproportionately affected by coronavirus disease 2019 (COVID-19). Detailed clinical analyses of multicultural hospitalized patient cohorts remain largely undescribed. Methods We performed regression, survival, and cumulative competing risk analyses to evaluate factors associated with mortality in patients admitted for COVID-19 in 3 large London hospitals between 25 February and 5 April, censored as of 1 May 2020. Results Of 614 patients (median age, 69 [interquartile range, 25] years) and 62% male), 381 (62%) were discharged alive, 178 (29%) died, and 55 (9%) remained hospitalized at censoring. Severe hypoxemia (adjusted odds ratio [aOR], 4.25 [95% confidence interval {CI}, 2.36–7.64]), leukocytosis (aOR, 2.35 [95% CI, 1.35–4.11]), thrombocytopenia (aOR [1.01, 95% CI, 1.00–1.01], increase per 109 decrease), severe renal impairment (aOR, 5.14 [95% CI, 2.65–9.97]), and low albumin (aOR, 1.06 [95% CI, 1.02–1.09], increase per gram decrease) were associated with death. Forty percent (n = 244) were from black, Asian, and other minority ethnic (BAME) groups, 38% (n = 235) were white, and ethnicity was unknown for 22% (n = 135). BAME patients were younger and had fewer comorbidities. Although the unadjusted odds of death did not differ by ethnicity, when adjusting for age, sex, and comorbidities, black patients were at higher odds of death compared to whites (aOR, 1.69 [95% CI, 1.00–2.86]). This association was stronger when further adjusting for admission severity (aOR, 1.85 [95% CI, 1.06–3.24]). Conclusions BAME patients were overrepresented in our cohort; when accounting for demographic and clinical profile of admission, black patients were at increased odds of death. Further research is needed into biologic drivers of differences in COVID-19 outcomes by ethnicity.

Illness Severity Predicts Death and Brain Injury in Asphyxiated Newborns Treated with Hypothermia

2018 ◽  
Vol 35 (10) ◽  
pp. 951-958 ◽  
Author(s):  
Hui Wang ◽  
Marc Beltempo ◽  
Emmanouil Rampakakis ◽  
Priscille-Nice Sanon ◽  
Stephanie Barbosa Vargas ◽  
...  
Keyword(s):  
Cohort Study ◽  
Brain Injury ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Adverse Outcome ◽  
Area Under The Curve ◽  
Illness Severity ◽  
Initial Severity ◽  
Baseline Characteristics

Objective To determine if illness severity during the first days of life predicts adverse outcome in asphyxiated newborns treated with hypothermia. Study Design We conducted a retrospective cohort study of asphyxiated newborns treated with hypothermia. Illness severity was calculated daily during the first 4 days of life using the Score for Neonatal Acute Physiology II (SNAP-II score). Adverse outcome (death and/or brain injury) was recorded. Differences in SNAP-II scores between the newborns with and without adverse outcome were assessed. Result 214 newborns were treated with hypothermia. The average SNAP-II score over the first 4 days of life was significantly worse in newborns developing adverse outcome. The average SNAP-II score was an excellent predictor of death (area under the curve [AUC]: 0.93; p < 0.001) and a fair predictor of adverse outcome (AUC: 0.73; p < 0.001). The average SNAP-II score remained a significant predictor of adverse outcome (odds ratio [95% confidence interval]: 1.08 [1.04–1.12]; p < 0.001), after adjusting for baseline characteristics, degree of initial asphyxial event, and initial severity of encephalopathy. Conclusion In asphyxiated newborns treated with hypothermia, not only the initial asphyxial event but also the illness severity during the first days of life was a significant predictor of death or brain injury.

scholarly journals Racial-ethnic disparities in case fatality ratio narrowed after age standardization: A call for race-ethnicity-specific age distributions in State COVID-19 data

2020 ◽  
Author(s):  
Ishaan Pathak ◽  
Yoonjoung Choi ◽  
Dazhi Jiao ◽  
Diana Yeung ◽  
Li Liu
Keyword(s):  
Racial Disparities ◽  
Ethnic Disparities ◽  
Case Fatality ◽  
Asian Population ◽  
Data Availability ◽  
White Population ◽  
Key Points ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Death Data

AbstractImportanceCOVID-19 racial disparities have gained significant attention yet little is known about how age distributions obscure racial-ethnic disparities in COVID-19 case fatality ratios (CFR).ObjectiveWe filled this gap by assessing relevant data availability and quality across states, and in states with available data, investigating how racial-ethnic disparities in CFR changed after age adjustment.Design/Setting/Participants/ExposureWe conducted a landscape analysis as of July 1st, 2020 and developed a grading system to assess COVID-19 case and death data by age and race in 50 states and DC. In states where age- and race-specific data were available, we applied direct age standardization to compare CFR across race-ethnicities. We developed an online dashboard to automatically and continuously update our results.Main Outcome and MeasureOur main outcome was CFR (deaths per 100 confirmed cases). We examined CFR by age and race-ethnicities.ResultsWe found substantial variations in disaggregating and reporting case and death data across states. Only three states, California, Illinois and Ohio, had sufficient age- and race-ethnicity-disaggregation to allow the investigation of racial-ethnic disparities in CFR while controlling for age. In total, we analyzed 391,991confirmed cases and 17,612 confirmed deaths. The crude CFRs varied from, e.g. 7.35% among Non-Hispanic (NH) White population to 1.39% among Hispanic population in Ohio. After age standardization, racial-ethnic differences in CFR narrowed, e.g. from 5.28% among NH White population to 3.79% among NH Asian population in Ohio, or an over one-fold difference. In addition, the ranking of race-ethnic-specific CFRs changed after age standardization. NH White population had the leading crude CFRs whereas NH Black and NH Asian population had the leading and second leading age-adjusted CFRs respectively in two of the three states. Hispanic population’s age-adjusted CFR were substantially higher than the crude. Sensitivity analysis did not change these results qualitatively.Conclusions and RelevanceThe availability and quality of age- and race-ethnic-specific COVID-19 case and death data varied greatly across states. Age distributions in confirmed cases obscured racial-ethnic disparities in COVID-19 CFR. Age standardization narrows racial-ethnic disparities and changes ranking. Public COVID-19 data availability, quality, and harmonization need improvement to address racial disparities in this pandemic.Key PointsQuestionWhat are the racial-ethnic disparities in COVID-19 case fatality ratios (CFR) across states after adjusting for age?FindingsWe conducted direct standardization among 391,991 COVID-19 cases and 17,612 deaths from California, Illinois and Ohio to compare age-adjusted CFR across race-ethnicities. The racial-ethnic disparities in CFR narrowed and the ranking changed after age standardization.MeaningAge distributions in confirmed cases obscured racial-ethnic disparities in COVID-19 CFR.

Racial, ethnic, and socioeconomic disparities in treatment outcomes in patients (pts) with diffuse large B-cell lymphoma (DLBCL): A U.S. real-world study using a de-identified electronic health record (EHR)-derived database.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18514-e18514
Author(s):  
Yanling Jin ◽  
Jia Li ◽  
Yong Mun ◽  
Anthony Masaquel ◽  
Sylvia Hu ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Real World ◽  
Eastern Cooperative Oncology Group ◽  
Ethnic Disparities ◽  
B Cell Lymphoma ◽  
Treatment Patterns ◽  
Disease Stage ◽  
Real World Data ◽  
Baseline Characteristics ◽  
Racial Ethnic

e18514 Background: DLBCL, an aggressive disease, is the most common subtype of non-Hodgkin lymphoma. Few studies have addressed socioeconomic and racial/ethnic disparities in treatment patterns and health outcomes for pts with DLBCL. We present a retrospective cohort study, leveraging real-world data from a nationwide database, to investigate these disparities. Methods: Pts with DLBCL treated with first-line (1L) therapy within 90 days of diagnosis were selected from the nationwide Flatiron Health EHR-derived de-identified database from January 2011 to May 2020. During the study, the de-identified data originated from approximately 280 US cancer clinics (̃800 sites of care). Pts’ baseline characteristics, treatment patterns, overall survival (OS), time to next therapy or death to any cause (TTNTD) were compared between race groups (non-Hispanic White [W], non-Hispanic African American [AA], Hispanic or Latino [H], non-Hispanic Asian [A]) and socioeconomic groups (Medicaid without Commercial [Medicaid] vs Commercial without Medicaid [Commercial]). Baseline characteristics were compared using Fisher’s exact, chi-squared or t-tests. Time to event endpoints were compared using Cox models adjusting baseline characteristics. Results: In total, 4,648 pts with DLBCL (82% W, 7% AA, 8% H, 3% A) were included. Compared with other race groups, W pts were older (mean age: 67 vs 60, 62, 62 [W vs AA, H, A]), had a higher proportion of pts with Eastern Cooperative Oncology Group score ≥2 (8% vs 5%, 4%, 4%), and fewer pts with Medicaid insurance (1.7% vs 5%, 6%, 3%). Across race groups, 1L treatments received were similar; 82% had R-CHOP. There were no significant differences in OS (P = 0.278; HR [AA, H, A vs W]: 0.87, 0.85, 0.84) and TTNTD (P = 0.158; HR: 0.89, 0.88, 1.19). There were statistically significant differences in time from diagnosis to treatment (P < 0.0001; HR: 0.83, 0.79, 1.12), although the magnitude of the median differences were relatively small (22, 24, 25, 19 days [W, AA, H, A]). In pts aged < 65, commercially insured pts had less advanced disease (Group Stage IV: 28% vs 59%), better OS (HR [95% CI]: 0.50 [0.31–0.81], P = 0.005) and later TTNTD (HR: 0.70 [0.48–1.03], P = 0.067) compared with Medicaid insured pts. In pts aged ≥65, commercially insured pts had similar disease stage, OS (HR: 1.09 [0.65–1.84], P = 0.756) and TTNTD (HR: 0.94 [0.61–1.44], P = 0.763) compared with Medicaid insured pts. Insurance was not a significant factor for time from diagnosis to treatment for pts aged < 65 (HR: 1.05 [0.80–1.37], P = 0.727) and ≥65 (HR: 1.05 [0.78–1.42], P = 0.742). Conclusions: In this analysis of over 4,500 pts with DLBCL treated in the real-world, access to commercial insurance was associated with health outcomes in pts under 65 years of age, possibly due to earlier diagnosis; race was not a significant factor.

Fate of Manuscripts Rejected by a Specialty Psychiatry Journal: A Retrospective Cohort Study

2021 ◽  
pp. 025371762110464
Author(s):  
Vikas Menon ◽  
Karumarakandy Puthiyapurayil Jayaprakashan ◽  
Natarajan Varadharajan ◽  
Shahul Ameen ◽  
Samir Kumar Praharaj
Keyword(s):  
Cohort Study ◽  
Peer Review ◽  
Random Sampling ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Multivariable Analysis ◽  
Original Research ◽  
Factors Associated ◽  
Indian Journal ◽  
Psychological Medicine

Background: Little is known about the publication outcomes of submissions rejected by specialty psychiatry journals. We aimed to investigate the publication fate of original research manuscripts previously rejected by the Indian Journal of Psychological Medicine (IJPM). Methods: A random sampling of manuscripts was drawn from all submissions rejected between January 1, 2018, and December 31, 2019. Using the titles of these papers and the author names, a systematic search of electronic databases was carried out to examine if these manuscripts have been published elsewhere or not. We extracted data on a range of scientific and nonscientific parameters from the journal’s manuscript management portal for every rejected manuscript. Multivariable analysis was used to detect factors associated with eventual publication. Results: Out of 302 manuscripts analyzed, 139 (46.0%) were published elsewhere; of these, only 18 articles (13.0%) were published in a journal with higher standing than IJPM. Manuscripts of foreign origin (odds ratio [OR] 1.77, 95% confidence interval [CI] = 1.06–2.97) and rejection following peer review or editorial re-review (OR 2.41, 95% CI = 1.22–4.74) were significantly associated with publication. Conclusion: Nearly half of the papers rejected by IJPM were eventually published in other journals, though such papers are more often published in journals with lower standing. Manuscripts rejected following peer review were more likely to reach full publication status compared to those which were desk rejected.

scholarly journals Impact of Comorbidities on Racial/Ethnic Disparities in Hypertension in the United States

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Franklin Opara ◽  
Kimberly Hawkins ◽  
Aparna Sundaram ◽  
Munira Merchant ◽  
Sandra Rasmussen ◽  
...  
Keyword(s):  
United States ◽  
African Americans ◽  
Odds Ratio ◽  
Ethnic Disparities ◽  
The United States ◽  
Prevalence Odds Ratio ◽  
Hypertension Prevalence ◽  
Ethnic Variability ◽  
Racial Ethnic ◽  
Relevant Covariates

Background. Racial/ethnic disparities in hypertension (HTN) prevalence continue to persist in United States. We aimed in this study to examine the racial/ethnic disparities in hypertension prevalence and to determine whether or not health disparities may be explained by racial/ethnic disparities in co-morbidities. Materials and Methods. A cross-sectional design was used to examine the prevalence of hypertension among African Americans (AAs), Caucasians, and Hispanics in the National Health Interview Survey, 2003. The overall sample comprised 30, 852 adults. Results. There was a statistically significant racial/ethnic variability in hypertension prevalence, with AA/Blacks with the highest prevalence, χ2=393.0 (3), P<0.01. Hypertension was associated with co-morbidities, age, education, physical inactivity, marital status, income, sex, alcohol, and cigarette consumption, but not insurance. Relative to Caucasians, AAA/Blacks were 43% more likely while Hispanics were 40% less likely to report being diagnosed with high blood pressure, prevalence odds ratio (POR)  =  1.43, 99% CI, 1.25–1.64, P=0.002, and POR  =  0.60, 99% CI, 0.55–0.66, P<0.001, respectively. After adjustment for the relevant covariates including co-morbidities, racial/ethnic disparities in hypertension persisted; thus compared to Caucasians, African Americans were 61% more likely to be told by their health care providers that they were hypertensive, adjusted prevalence odds ratio (APOR)  =  1.61, 99% CI, 1.39–1.86, P<0.001. In contrast, Hispanics were 27% less likely to be diagnosed with hypertension compared to Caucasians, APOR  =  0.73, 99% CI, 0.68–0.79, P<0.001. Conclusions. There was racial/ethnic variability in hypertension prevalence in this large sample of non-institutionalized US residents, with the highest prevalence of hypertension observed among African Americans. These disparities were not removed after controlling for relevant covariates including co-morbidities.

Incidence of Unintentional Flow of Contrast into the Facet Joints During Fluoroscopy-Guided Cervical Interlaminar Epidural Injections: A Retrospective Cohort Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1362-1368
Author(s):  
Yoo Jung Park ◽  
Joon-Yong Jung ◽  
Gyuho Choe ◽  
Yu Jung Lee ◽  
Jiyoung Lee ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Retrospective Cohort ◽  
Adjusted Odds Ratio ◽  
Epidural Injection ◽  
Facet Joints ◽  
Multivariate Logistic Regression ◽  
Single Institution ◽  
Factors Associated ◽  
Epidural Injections ◽  
Interlaminar Epidural Injection

Abstract Objective We sometimes encounter unintentional flow of contrast into the facet joints during cervical interlaminar epidural injection, which leads to false-positive epidural injection. The purposes of this study were to evaluate the rate of facet flow of contrast and to investigate various factors associated with injection into the space of Okada during fluoroscopy-guided cervical interlaminar epidural injection. Setting and Subjects Images from consecutive cases of fluoroscopy-guided cervical interlaminar epidural injection performed at a single institution between July 2015 and July 2018 were obtained and reviewed. Methods Cases of epidural injection were classified as either facet flow or no facet flow. Multivariate logistic regression was used to identify the predictive factors of unintended injection into the Okada space. Results A total of 2,006 cases were included. Intra-articular flow was identified in 6.0% of cases (121/2,006). All cases of flow of contrast into the facet joints were recognized, and appropriate epidurograms were obtained during the procedures. The highest rate of unintended facet flow of the contrast (10.1%, 44/436) occurred at C5–6. Cervical interlaminar epidural injection at C5–6 and above (adjusted odds ratio [aOR] = 1.929, P = 0.001) and the paramidline approach for epidural injection (aOR = 2.427, P &lt; 0.001) were associated with injection into the space of Okada. Conclusions We detected injection into the space of Okada during fluoroscopy-guided cervical interlaminar epidural injection in 6.0% of procedures. Cervical interlaminar epidural injection at C5–6 and above and the paramidline approach for epidural injection were positive predictors of unintentional facet flow of the contrast.

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