Epidemiology and Trends of Hereditary Hemorrhagic Telangiectasia in the United States

Background To our knowledge, no national studies have investigated the epidemiology of hereditary hemorrhagic telangiectasia (HHT) in the United States since the incorporation of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD-10 CM). Objective Our objective is to analyze the epidemiology of HHT from 2013 to 2017 and to determine the relationships between epistaxis and other associated complications of this rare disease. Methods We analyzed the epidemiology of HHT between 2013 and 2017 by accessing data of 87 709 738 patients from the Clinformatics Data Mart using ICD-9 CM and ICD-10 CM codes. Variables analyzed included age, gender, region, clinical setting of diagnosis, hospitalizations, and complications. Bivariate analyses using generalized linear models were conducted to determine the likelihood of HHT patients with epistaxis enduring associated life-threatening complications such as cerebral hemorrhage, thrombosis, and pulmonary hemorrhage compared to HHT patients without epistaxis during the study period. Results The prevalence of HHT increased from 6.1 to 12.1 per 100 000 persons, with patients of ages 18 to 29 years and those older than 60 years seeing the greatest percent increase. The prevalence of HHT in the Southern United States saw a 147% increase. Compared to HHT patients without epistaxis, HHT patients with epistaxis were 3.4 times more likely to experience pulmonary hemorrhage, 3.3 times more likely to have pulmonary emboli, 2.8 times more likely to experience cerebral hemorrhage, and 2.0 times more likely to have thrombosis during the study period. Conclusion Our national study has provided the first incidence and prevalence rates of HHT in the United States since the incorporation of the ICD-10 CM. HHT patients with epistaxis require prompt multidisciplinary treatment of their condition due to their increased risk of life-threatening complications.

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Deaths from necrotizing fasciitis in the United States, 2003–2013

Epidemiology and Infection ◽

10.1017/s0950268815002745 ◽

2015 ◽

Vol 144 (6) ◽

pp. 1338-1344 ◽

Cited By ~ 30

Author(s):

N. ARIF ◽

S. YOUSFI ◽

C. VINNARD

Keyword(s):

United States ◽

Necrotizing Fasciitis ◽

Incidence Rate ◽

Racial Differences ◽

Cause Of Death ◽

The United States ◽

Crude Mortality Rate ◽

Crude Mortality ◽

Icd 10 ◽

Life Threatening

SUMMARYNecrotizing fasciitis (NF) is a life-threatening infection requiring urgent surgical and medical therapy. Our objective was to estimate the mortality burden of NF in the United States, and to identify time trends in the incidence rate of NF-related mortality. We obtained data from the National Center for Health Statistics, which receives information from death certificates from all states, including demographic information and cause of death. The U.S. Multiple Cause of Death Files were searched from 2003 to 2013 for a listing of NF (ICD-10 code M72.6) as either the underlying or contributing cause of death. We identified a total of 9871 NF-related deaths in the United States between 2003 and 2013, corresponding to a crude mortality rate of 4·8 deaths/1 000 000 person-years, without a significant time trend. Compared to white individuals, the incidence rate of NF-associated death was greater in black, Hispanic, and American Indian individuals, and lower in Asian individuals. Streptococcal infection was most commonly identified in cases where a pathogen was reported. Diabetes mellitus and obesity were more commonly observed in NF-related deaths compared to deaths due to other causes. Racial differences in the incidence of NF-related deaths merits further investigation.

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Abstract TMP13: The Prevalence of Microbleeds in Moyamoya Disease and Moyamoya Syndrome in the United States

Stroke ◽

10.1161/str.47.suppl_1.tmp13 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Mo Chen ◽

Sepand Salehian ◽

Maki Mukawa-Sawada ◽

Marco Pinho ◽

Babu Welch ◽

...

Keyword(s):

United States ◽

Moyamoya Disease ◽

Cerebral Hemorrhage ◽

Hemorrhagic Stroke ◽

Asian Population ◽

The United States ◽

Moyamoya Syndrome ◽

Increased Risk ◽

Ischemic Events

Introduction: Silent cerebral microbleeds (CMB) are common in Moyamoya Disease (MMD) and Moyamoya syndrome (MMS) in Asia. The incidence was reported to be 30-40%. The presence of CMB was found to be a predictor for subsequent cerebral hemorrhage in MMD. The significance of CMB in MMD/MMS in non-Asian population has not been reported. We try to investigate the prevalence of CMB in MMD/MMS in United States and its predictive value for subsequent cerebral hemorrhage. Methods: Moyamoya Database was established in our institution after reviewing patients with ICD9 code of Moyamoya Disease or Moyamoya Syndrome or cerebrovascular occlusive disease from 2007 to 2015. Patients in the database were reviewed retrospectively and included in the study if there were MR images (including GRE, SWI or T2* sequences) at diagnosis or during follow up and available for review. Patients with poor image quality were excluded. Patients were noted to have microbleeds if it was found on initial or follow up MRI. Multivariate logistic regression analysis was used to identify clinical and imaging predictors of CMB. Results: Sixty-three females and fourteen males were included with average age of 39 ± 13 at the time of diagnosis. The majorities were MMD (79.2%) and presented with ischemic events (79.2%). Hemorrhagic stroke was found in 9 (11.7%) patients before diagnosis. Ethnicity included Caucasian (61%), Asian (10.4%), Black (11.7%), and Hispanic (16.9%). Of total 77 patients, 7 (9.1%) had CMB but none of them presented with hemorrhagic stroke. During follow up of average 36 ± 29 months in these 7 patients, no cerebral hemorrhage was reported while ischemic events occurred in 2 (28.6%) patients. Of 70 patients without CMB, 51 had follow up of average 47 ± 46 months. One (2%) had cerebral hemorrhage while 12 (23.5%) had ischemic events. No independent predictors for CMB were identified among age, gender, ethnicity, etiology, presenting stroke, and comorbidities. Conclusions: Silent CMB was less prevalent in MMD/MMS in United States than in Asia. No specific risk factors were identified to be associated with the presence of silent CMB. It was not associated with increased risk of subsequent cerebral hemorrhage in non-Asian population. Further studies are needed to confirm these findings.

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Migration for Mission

10.1093/oso/9780190933098.001.0001 ◽

2019 ◽

Cited By ~ 1

Author(s):

Mary Johnson ◽

Patricia Wittberg ◽

Mary Gautier ◽

Thu Do

Keyword(s):

United States ◽

Qualitative Data ◽

The United States ◽

National Study ◽

Catholic Sisters ◽

Long Line ◽

Catholic Organizations ◽

To Come ◽

Washington University ◽

The Trinity

This book presents quantitative and qualitative data from the first-ever national study of international Catholic sisters in the United States, the Trinity Washington University/CARA Study. International sisters are defined as those born outside the United States and currently ministering, studying, or in residence in this country. The book begins with a chapter that locates current international sisters in the long line of sisters who have come to this country since the eighteenth century. The book identifies the sisters of today, describes the pathways they used to come here, their levels of satisfaction, their concerns and contributions, the issue of immigration status, the challenges of sister students, and the role and mission of Catholic organizations assisting immigrants in general, and international sisters in particular. The book ends with implications of the research and recommendations regarding resources, ministries, and structures of support for international sisters.

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Dietary patterns related to total mortality and cancer mortality in the United States

Cancer Causes & Control ◽

10.1007/s10552-021-01478-2 ◽

2021 ◽

Author(s):

Marcela R. Entwistle ◽

Donald Schweizer ◽

Ricardo Cisneros

Keyword(s):

United States ◽

Dietary Patterns ◽

Cancer Mortality ◽

Cox Regression ◽

Total Mortality ◽

Principal Component ◽

The United States ◽

Red Meat ◽

Increased Risk ◽

All Cause Mortality

Abstract Purpose This study investigated the association between dietary patterns, total mortality, and cancer mortality in the United States. Methods We identified the four major dietary patterns at baseline from 13,466 participants of the NHANES III cohort using principal component analysis (PCA). Dietary patterns were categorized into ‘prudent’ (fruits and vegetables), ‘western’ (red meat, sweets, pastries, oils), ‘traditional’ (red meat, legumes, potatoes, bread), and ‘fish and alcohol’. We estimated hazard ratios for total mortality, and cancer mortality using Cox regression models. Results A total of 4,963 deaths were documented after a mean follow-up of 19.59 years. Higher adherence to the ‘prudent’ pattern was associated with the lowest risk of total mortality (5th vs. 1st quintile HR 0.90, 95% CI 0.82–0.98), with evidence that all-cause mortality decreased as consumption of the pattern increased. No evidence was found that the ‘prudent’ pattern reduced cancer mortality. The ‘western’ and the ‘traditional’ patterns were associated with up to 22% and 16% increased risk for total mortality (5th vs. 1st quintile HR 1.22, 95% CI 1.11–1.34; and 5th vs. 1st quintile HR 1.16, 95% CI 1.06–1.27, respectively), and up to 33% and 15% increased risk for cancer mortality (5th vs. 1st quintile HR 1.33, 95% CI 1.10–1.62; and 5th vs. 1st quintile HR 1.15, 95% CI 1.06–1.24, respectively). The associations between adherence to the ‘fish and alcohol’ pattern and total mortality, and cancer mortality were not statistically significant. Conclusion Higher adherence to the ‘prudent’ diet decreased the risk of all-cause mortality but did not affect cancer mortality. Greater adherence to the ‘western’ and ‘traditional’ diet increased the risk of total mortality and mortality due to cancer.

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Household COVID-19 risk and in-person schooling

Science ◽

10.1126/science.abh2939 ◽

2021 ◽

pp. eabh2939

Author(s):

Justin Lessler ◽

M. Kate Grabowski ◽

Kyra H. Grantz ◽

Elena Badillo-Goicoechea ◽

C. Jessica E. Metcalf ◽

...

Keyword(s):

United States ◽

Online Survey ◽

Positive Association ◽

The United States ◽

Mitigation Measures ◽

Office Work ◽

School Based ◽

Increased Risk ◽

Extra Curricular Activities ◽

Low Levels

In-person schooling has proved contentious and difficult to study throughout the SARS-CoV-2 pandemic. Data from a massive online survey in the United States indicates an increased risk of COVID-19-related outcomes among respondents living with a child attending school in-person. School-based mitigation measures are associated with significant reductions in risk, particularly daily symptoms screens, teacher masking, and closure of extra-curricular activities. A positive association between in-person schooling and COVID-19 outcomes persists at low levels of mitigation, but when seven or more mitigation measures are reported, a significant relationship is no longer observed. Among teachers, working outside the home was associated with an increase in COVID-19-related outcomes, but this association is similar to other occupations (e.g., healthcare, office work). While in-person schooling is associated with household COVID-19 risk, this risk can likely be controlled with properly implemented school-based mitigation measures.

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Altitude and risk of sudden unexpected infant death in the United States

Scientific Reports ◽

10.1038/s41598-021-81613-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Richard Johnston ◽

Xiaohan Yan ◽

Tatiana M. Anderson ◽

Edwin A. Mitchell

Keyword(s):

United States ◽

Logistic Regression ◽

Infant Death ◽

The United States ◽

Sudden Infant ◽

Data Set ◽

Live Births ◽

Sudden Unexpected Infant Death ◽

Increased Risk ◽

Unexpected Infant Death

AbstractThe effect of altitude on the risk of sudden infant death syndrome (SIDS) has been reported previously, but with conflicting findings. We aimed to examine whether the risk of sudden unexpected infant death (SUID) varies with altitude in the United States. Data from the Centers for Disease Control and Prevention (CDC)’s Cohort Linked Birth/Infant Death Data Set for births between 2005 and 2010 were examined. County of birth was used to estimate altitude. Logistic regression and Generalized Additive Model (GAM) were used, adjusting for year, mother’s race, Hispanic origin, marital status, age, education and smoking, father’s age and race, number of prenatal visits, plurality, live birth order, and infant’s sex, birthweight and gestation. There were 25,305,778 live births over the 6-year study period. The total number of deaths from SUID in this period were 23,673 (rate = 0.94/1000 live births). In the logistic regression model there was a small, but statistically significant, increased risk of SUID associated with birth at > 8000 feet compared with < 6000 feet (aOR = 1.93; 95% CI 1.00–3.71). The GAM showed a similar increased risk over 8000 feet, but this was not statistically significant. Only 9245 (0.037%) of mothers gave birth at > 8000 feet during the study period and 10 deaths (0.042%) were attributed to SUID. The number of SUID deaths at this altitude in the United States is very small (10 deaths in 6 years).

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Time to First Cigarette and Self-Reported Health Among US Adult Smokers

Tobacco Use Insights ◽

10.1177/1179173x18825262 ◽

2019 ◽

Vol 12 ◽

pp. 1179173X1882526 ◽

Cited By ~ 1

Author(s):

Baksun Sung

Keyword(s):

United States ◽

Propensity Score ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Smoking Behavior ◽

The United States ◽

Elevated Risk ◽

Poor Health ◽

Increased Risk ◽

Reported Health

Background: Numerous studies have reported that shorter time to first cigarette (TTFC) is linked to elevated risk for smoking-related morbidity. However, little is known about the influence of early TTFC on self-reported health among current smokers. Hence, the objective of this study was to examine the association between TTFC and self-reported health among US adult smokers. Methods: Data came from the 2012-2013 National Adult Tobacco Survey (NATS). Current smokers aged 18 years and older (N = 3323) were categorized into 2 groups based on TTFC: ≤ 5 minutes (n = 1066) and >5 minutes (n = 2257). Propensity score matching (PSM) was used to control selection bias. Results: After adjusting for sociodemographic and smoking behavior factors, current smokers with early TTFC had higher odds for poor health in comparison with current smokers with late TTFC in the prematching (adjusted odds ratio [AOR] = 1.65; 95% confidence interval [CI] = 1.31-2.08) and postmatching (AOR = 1.60; 95% CI = 1.22-2.09) samples. Conclusions: In conclusion, smokers with early TTFC were associated with increased risk of poor health in the United States. To reduce early TTFC, elaborate efforts are needed to educate people about harms of early TTFC and benefits of stopping early TTFC.

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Safety and Efficacy of Argatroban in the Management of Heparin-Induced Thrombocytopenia

Clinical medicine Blood disorders ◽

10.4137/cmbd.s5118 ◽

2011 ◽

Vol 4 ◽

pp. CMBD.S5118 ◽

Cited By ~ 1

Author(s):

Bernd Saugel ◽

Roland M. Schmid ◽

Wolfgang Huber

Keyword(s):

Arterial Thrombosis ◽

Pharmacokinetic Profile ◽

The United States ◽

Heparin Therapy ◽

Direct Thrombin Inhibitor ◽

Thrombin Inhibitor ◽

Heparin Induced Thrombocytopenia ◽

Safety And Efficacy ◽

Increased Risk ◽

Life Threatening

Heparin-induced thrombocytopenia (HIT) is a life-threatening adverse reaction to heparin therapy that is characterized by thrombocytopenia and an increased risk of venous and arterial thrombosis. According to guidelines, in patients with strongly suspected or confirmed HIT all sources of heparin have to be discontinued and an alternative, nonheparin anticoagulant for HIT treatment must immediately be started. For both the prophylaxis of thrombembolic events in HIT and the treatment of HIT with thrombosis the direct thrombin inhibitor argatroban is approved in the United States. The objective of this review is to describe the mechanism of action and the pharmacokinetic profile of argatroban, to characterize argatroban regarding its safety and therapeutic efficacy and to discuss its place in therapy in HIT.

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Sickle Cell Trait and Renal Function in Hispanics in the United States: the Northern Manhattan Study

Ethnicity & Disease ◽

10.18865/ed.27.1.11 ◽

2017 ◽

Vol 27 (1) ◽

pp. 11 ◽

Cited By ~ 7

Author(s):

Nicole D. Dueker ◽

David Della-Morte ◽

Tatjana Rundek ◽

Ralph L. Sacco ◽

Susan H. Blanton

Keyword(s):

United States ◽

Chronic Kidney Disease ◽

African Americans ◽

Kidney Disease ◽

Sickle Cell ◽

Sickle Cell Trait ◽

The United States ◽

Genetic Mutation ◽

Single Mutation ◽

Increased Risk

Sickle cell anemia (SCA) is a common hematological disorder among individuals of African descent in the United States; the disorder results in the production of abnormal hemoglobin. It is caused by homozygosity for a genetic mutation in HBB; rs334. While the presence of a single mutation (sickle cell trait, SCT) has long been considered a benign trait, recent research suggests that SCT is associated with renal dysfunction, including a decrease in estimated glomerular filtration rate (eGFR) and increased risk of chronic kidney disease (CKD) in African Americans. It is currently unknown whether similar associations are observed in Hispanics. Therefore, our study aimed to determine if SCT is associated with mean eGFR and CKD in a sample of 340 Dominican Hispanics from the Northern Manhattan Study. Using regression analyses, we tested rs334 for association with eGFR and CKD, adjusting for age and sex. eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation and CKD was defined as eGFR < 60 mL/min/1.73 m2. Within our sample, there were 16 individuals with SCT (SCT carriers). We found that SCT carriers had a mean eGFR that was 12.12 mL/min/1.73m2 lower than non-carriers (P=.002). Additionally, SCT carriers had 2.72 times higher odds of CKD compared with non-carriers (P=.09). Taken together, these novel results show that Hispanics with SCT, as found among African Americans with SCT, may also be at increased risk for kidney disease.Ethn Dis. 2017; 27(1):11-14; doi:10.18865/ed.27.1.11.

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