scholarly journals The prevalence of MS in the United States

Neurology ◽  
2019 ◽  
Vol 92 (10) ◽  
pp. e1029-e1040 ◽  
Author(s):  
Mitchell T. Wallin ◽  
William J. Culpepper ◽  
Jonathan D. Campbell ◽  
Lorene M. Nelson ◽  
Annette Langer-Gould ◽  
...  

ObjectiveTo generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets.MethodsA validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017.ResultsThe estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1–310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1–451.6) for women and 159.7 (95% CI 158.7–160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017.ConclusionThe estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nathan Maassel ◽  
Abbie Saccary ◽  
Daniel Solomon ◽  
David Stitelman ◽  
Yunshan Xu ◽  
...  

Abstract Background Despite a national decrease in emergency department visits in the United States during the first 10 months of the pandemic, preliminary Consumer Product Safety Commission data indicate increased firework-related injuries. We hypothesized an increase in firework-related injuries during 2020 compared to years prior related to a corresponding increase in consumer firework sales. Methods The National Electronic Injury Surveillance System (NEISS) was queried from 2018 to 2020 for cases with product codes 1313 (firework injury) and narratives containing “fireworks”. Population-based national estimates were calculated using US Census data, then compared across the three years of study inclusion. Patient demographic and available injury information was also tracked and compared across the three years. Firework sales data obtained from the American Pyrotechnics Association were determined for the same time period to examine trends in consumption. Results There were 935 firework-related injuries reported to the NEISS from 2018 to 2020, 47% of which occurred during 2020. National estimates for monthly injuries per million were 1.6 times greater in 2020 compared to 2019 (p < 0.0001) with no difference between 2018 and 2019 (p = 0.38). The same results were found when the month of July was excluded. Firework consumption in 2020 was 1.5 times greater than 2019 or 2018, with a 55% increase in consumer fireworks and 22% decrease in professional fireworks sales. Conclusions Firework-related injures saw a substantial increase in 2020 compared to the two years prior, corroborated by a proportional increase in consumer firework sales. Increased incidence of firework-related injuries was detected even with the exclusion of the month of July, suggesting that the COVID-19 pandemic may have impacted firework epidemiology more broadly than US Independence Day celebrations.


Author(s):  
Earl H. Fry

This article examines the ebb and flow of the Quebec government’s economic and commercial relations with the United States in the period 1994–2017. The topic demonstrates the impact of three major forces on Quebec’s economic and commercial ties with the US: (1) the North American Free Trade Agreement (NAFTA) which became operational in 1994 and was fully implemented over a 15-year period; (2) the onerous security policies put in place by the US government in the decade following the horrific events of 11 September 2001; and (3) changing economic circumstances in the United States ranging from robust growth to the worst recession since the Great Depression of the 1930s. The article also indicates that the Quebec government continues to sponsor a wide range of activities in the United States, often more elaborate and extensive than comparable activities pursued by many nation-states with representation in the US. 1 1 Stéphane Paquin, ‘Quebec-U.S. Relations: The Big Picture’, American Review of Canadian Studies 46, no. 2 (2016): 149–61.


Author(s):  
D. V. Dorofeev

The research is devoted to the study of the origin of the historiography of the topic of the genesis of the US foreign policy. The key thesis of the work challenges the established position in the scientific literature about the fundamental role of the work of T. Lyman, Jr. «The diplomacy of the United States: being an account of the foreign relations of the country, from the first treaty with France, in 1778, to the Treaty of Ghent in 1814, with Great Britain», published in 1826. The article puts forward an alternative hypothesis: the emergence of the historiography of the genesis of the foreign policy of the United States occurred before the beginning of the second quarter of the XIX century – during the colonial period and the first fifty years of the North American state. A study of the works of thirty-five authors who worked during the 1610s and 1820s showed that amater historians expressed a common opinion about North America’s belonging to the Eurocentric system of international relations; they were sure that both the colonists and the founding fathers perceived international processes on the basis of raison d’être. The conceptualization of the intellectual heritage of non-professional historians allowed us to distinguish three interpretations of the origin of the United States foreign policy: «Autochthonous» – focused on purely North American reasons; «Atlantic» – postulated the borrowing of European practice of international relations by means of the system of relations that developed in the Atlantic in the XVII–XVIII centuries; «Imperial» – stated the adaptation of the British experience. The obtained data refute the provisions of scientific thought of the XX–XXI centuries and create new guidelines for further study of the topic.


1991 ◽  
Vol 11 (4) ◽  
pp. 357-398 ◽  
Author(s):  
Michael L. Cohen

ABSTRACTThe census is a social fact, the outcome of a process that involves the interaction of public laws and institutions and citizens' responses to an official inquiry. However, it is not a ‘hard’ fact. Reasons for inevitable defects in the census count are listed in the first section; the second section reports efforts by the US Census Bureau to identify sources of error in census coverage, and make estimates of the size of the errors. The use of census data for policy purposes, such as political representation and allocating funds, makes these defects controversial. Errors may be removed by making adjustments to the initial census count. However, because adjustment reallocates resources between groups, it has become the subject of political conflict. The paper describes the conflict between statistical practices, laws and public policy about census adjustment in the United States, and concludes by considering the extent to which causes in America are likely to be found in other countries.


Author(s):  
Yizhou Ye ◽  
Sudhakar Manne ◽  
William R Treem ◽  
Dimitri Bennett

Abstract Background The latest estimate of the prevalence of inflammatory bowel disease (IBD) in the United States was based on 2009 data, which indicates a need for an up-to-date re-estimation. The objectives of this study were to investigate the prevalence of all forms of IBD including ulcerative colitis (UC), Crohn’s disease (CD), and IBD unspecified (IBDU). Methods Pediatric (age 2–17) and adult (age ≥18) IBD patients were identified from 2 large claims databases. For each year between 2007 and 2016, prevalence was calculated per 100,000 population and standardized based on the 2016 national Census. A fixed-effects meta-analytical model was used for overall prevalence. Results The pediatric prevalence of IBD overall increased by 133%, from 33.0/100,000 in 2007 to 77.0/100,000 in 2016. Among children, CD was twice as prevalent as UC (45.9 vs 21.6). Prevalence was higher in boys than girls for all forms of IBD, in contrast to the adult population where the prevalence was higher in women than men. We also found that the 10–17 age subgroup was the major contributor to the rising pediatric IBD prevalence. For adults, the prevalence of IBD overall increased by 123%, from 214.9 in 2007 to 478.4 in 2016. The prevalence rates of UC and CD were similar (181.1 vs 197.7) in 2016. Conclusions Inflammatory bowel disease continues to affect a substantial proportion of the US population. In 2016, 1 in 209 adults and 1 in 1299 children aged 2–17 were affected by IBD. Prevalence of IBD has been increasing compared with previously published 2009 data.


Author(s):  
Maritza E. Cárdenas

The use of the term “Central American” as an identity category is neither new nor restricted to the US diaspora. However, it is within the last forty years and in the geopolitical setting of the United States that a thriving identity politics has developed. It is during this time period that the use of the term Central American has emerged to denote a tactical American pan-ethnic social identity. This act of consciously employing the term “Central American” as a unification strategy for peoples from the isthmus in the United States echoes other US-based ethnoracial identity politics. Such movements often utilize a pan-ethnic term not only to advocate on the behalf of a racialized minoritarian community but also seeking to provide them a space of belonging by focusing on sociopolitical, cultural, and ethnic commonalities. As other identity markers in the United States such as “Asian American” and “African American” illustrate, Central Americans are not the first population to utilize a region as a strategic unifying term of self-identification. Yet, unlike these other US ethnoracial categories, for those who identify as “Central American” the term “Central America” often connotes not simply a geographic space but also a historical formation that advances the notion that individuals from the isthmus comprise a distinct but common culture. Another key difference from other US ethnoracial identities is that use of the term “Central American” in US cultural politics emerged during a historical era where the broader collective terms “Hispanic” or “Latino” were already in place. The creation and deployment of “Central American” is therefore an alternative to this other supra-ethnic identity category, as subjects view this isthmian-based term as being able to simultaneously create a broader collective while still invoking a type of geographic and cultural specificity that is usually associated with national identities.


2000 ◽  
Vol 26 (1) ◽  
pp. 69-82 ◽  
Author(s):  
ANTHONY PAYNE

United States–Caribbean relations over the period of the last thirty or forty years have rarely—if ever—been analysed in a thoroughly satisfying way. It is a strange omission in the international relations literature given the proximity of the United States to the Caribbean, and vice versa. But the fact is that most accounts of the relationship have fallen prey to a powerful, but ultimately misleading, mythology by which small, poor, weak, dependent entities in the Caribbean have either created trouble for, or alternatively been confronted by, the ‘colossus to the north’ that is the United States in whose ‘backyard’ they unfortunately have to reside. Virtually all analysts of the US–Caribbean relationship have thus drawn a picture marked at heart by the notion of an inherently unequal struggle between forces of a different order and scale. Within this broad metaphor the only major difference of interpretation has reflected the competing theories of power in the international system developed by the realist and structuralist schools.


2009 ◽  
Vol 36 (1) ◽  
pp. 63-67 ◽  
Author(s):  
MICHAEL M. WARD

ObjectiveTo determine if the incidence of endstage renal disease (ESRD) due to lupus nephritis has decreased from 1996 to 2004.MethodsPatients age 15 years or older with incident ESRD due to lupus nephritis in 1996–2004 and living in one of the 50 United States or the District of Columbia were identified using the US Renal Data System, a national population-based registry of all patients receiving renal replacement therapy for ESRD. Incidence rates were computed for each calendar year, using population estimates of the US census as denominators.ResultsOver the 9-year study period, 9199 new cases of ESRD due to lupus nephritis were observed. Incidence rates, adjusted to the age, sex, and race composition of the US population in 2000, were 4.4 per million in 1996 and 4.9 per million in 2004. Compared to the pooled incidence rate in 1996–1998, the relative risk of ESRD due to lupus nephritis in 1999–2000 was 0.99 (95% CI 0.93–1.06), in 2001–2002 was 0.99 (95% CI 0.92–1.06), and in 2003–2004 was 0.96 (95% CI 0.89–1.02). Findings were similar in analyses stratified by sex, age group, race, and socioeconomic status.ConclusionThere was no decrease in the incidence of ESRD due to lupus nephritis between 1996 and 2004. This may reflect the limits of effectiveness of current treatments, or limitations in access, use, or adherence to treatment.


Author(s):  
Heather Kalish ◽  
Carleen Klumpp-Thomas ◽  
Sally Hunsberger ◽  
Holly Ann Baus ◽  
Michael P Fay ◽  
...  

ABSTRACTAsymptomatic SARS-CoV-2 infection and delayed implementation of diagnostics have led to poorly defined viral prevalence rates. To address this, we analyzed seropositivity in US adults who have not previously been diagnosed with COVID-19. Individuals with characteristics that reflect the US population (n = 11,382) and who had not previously been diagnosed with COVID-19 were selected by quota sampling from 241,424 volunteers (ClinicalTrials.govNCT04334954). Enrolled participants provided medical, geographic, demographic, and socioeconomic information and 9,028 blood samples. The majority (88.7%) of samples were collected between May 10th and July 31st, 2020. Samples were analyzed via ELISA for anti-Spike and anti-RBD antibodies. Estimation of seroprevalence was performed by using a weighted analysis to reflect the US population. We detected an undiagnosed seropositivity rate of 4.6% (95% CI: 2.6 – 6.5%). There was distinct regional variability, with heightened seropositivity in locations of early outbreaks. Subgroup analysis demonstrated that the highest estimated undiagnosed seropositivity within groups was detected in younger participants (ages 18-45, 5.9%), females (5.5%), Black/African American (14.2%), Hispanic (6.1%), and Urban residents (5.3%), and lower undiagnosed seropositivity in those with chronic diseases. During the first wave of infection over the spring/summer of 2020 an estimate of 4.6% of adults had a prior undiagnosed SARS-CoV-2 infection. These data indicate that there were 4.8 (95% CI: 2.8-6.8) undiagnosed cases for every diagnosed case of COVID-19 during this same time period in the United States, and an estimated 16.8 million undiagnosed cases by mid-July 2020.


2020 ◽  
Vol 19 (3) ◽  
pp. 2497
Author(s):  
V. G. Vilkov ◽  
S. A. Shalnova ◽  
Yu. A. Balanova ◽  
S. E. Evstifeeva ◽  
A. E. Imaeva ◽  
...  

Aim. To study the prevalence of hypotension according to several criteria in the Russia and the USA.Material and methods. We used data of Russian population studies performed in 1975-1982 and ESSE-RF study performed in 2012-2014 at the National Medical Research Center for Therapy and Preventive Medicine. A comparison was made with the data of cross-sectional stu - dies of the US population — National Health and Nutrition Examination Survey (NHANES): NHANES II (1976-1980) and Continuous NHANES (2007-2012). We analyzed age, sex, and systolic and diastolic blood pressure. The prevalence of individuals with hypotension was calculated in men and women of five age groups using four different criteria for hypertension.Results. The prevalence of hypotension in studies of different years according to different criteria was as follows: in the Russia — 0,3-9,0% in men and 2-15% in women; in the USA — 5-30% in men and 8-45% in women. In age group >30 years, the prevalence of hypotension in Russia, by most criteria, decreased approximately by 50% in men and did not change in women. In the United States, according to all criteria, the prevalence in men and women has increased 2-3 times.Conclusion. The prevalence of hypotension in the adult population ranges from decimal percentages to 45% and varies many times depending on the selected criterion.


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