Browsing by Author "Camargo, Carlos A., Jr."

Now showing 1 - 4 of 4
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    Associations of alpha and gamma-tocopherol during early life with lung function in childhood
    (Elsevier, 2020) Kumar, Rajesh; Ferrie, Ryan; Balmert, Lauren; Kienzi, Matthew; Rifas-Shiman, Sheryl L.; Gold, Diane R.; Sordillo, Joanne E.; Kleinman, Ken; Camargo, Carlos A., Jr.; Litonjua, Augusto A.; Oken, Emily; Cook-Mills, Joan; Pediatrics, School of Medicine
    Background: Tocopherol isoforms may regulate child lung growth and spirometric measures. Objective: Our aim was to determine the extent to which plasma a-tocopherol (a-T) or g-tocopherol (g-T) isoform levels in early childhood or in utero are associated with childhood lung function. Methods: We included 622 participants in the Project Viva cohort who had lung function at a mid-childhood visit (age 6-10 years). Maternal and child tocopherol isoform levels were measured by HPLC at the second trimester and 3 years of age, respectively. Multivariable linear regression models (adjusted for mid-childhood body mass index z scores, maternal education, smoking in pregnancy, and prenatal particulate matter with diameter of <2.5 micrometers (PM2.5) particulate exposure) stratified by tertiles of child g-T level were used to assess the association of a-T levels with FEV1 and forced vital capacity (FVC) percent predicted. Similarly, models stratified by child a-T tertile evaluated associations of g-T levels with lung function. We performed similar analyses with maternal second trimester tocopherol isoform levels. Results: The median maternal second trimester a-T level was 63 mM (interquartile range 5 47-82). The median early-childhood level was 25 mM (interquartile range 5 20-33 mM). In the lowest tertile of early-childhood g-T, children with a higher a-T level (per 10 mM) had a higher mid-childhood FEV1 percent predicted (b 5 3.09; 95% CI 5 0.58-5.59 and a higher FVC percent predicted (b 5 2.77; 95% CI 5 0.47-5.06). This protective association of a-T was lost at higher g-T levels. We did not see any consistent associations of second trimester levels of either a-T or g-T with mid-childhood FEV1 or FVC. Conclusion: When g-T levels were in the lowest tertile, a higher early-childhood a-T level was associated with better lung function at mid-childhood. Second trimester maternal plasma a-T concentration was 3-fold higher than in the adult nonpregnant female population.
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    Asymptomatic Bacteriuria versus Symptom Underreporting in Older Emergency Department Patients with Suspected Urinary Tract Infection
    (Wiley, 2020-11) Caterino, Jeffrey M.; Stephens, Julie A.; Camargo, Carlos A., Jr.; Wexler, Randell; Hebert, Courtney; Southerland, Lauren T.; Hunold, Katherine M.; Hains, David S.; Bischof, Jason J.; Wei, Lai; Wolfe, Alan J.; Schwaderer, Andrew; Pediatrics, School of Medicine
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    Increased Body Mass Index and Metabolic Syndrome Are Associated with Poor Outcomes in SARS-CoV-2-Positive Emergency Department Patients
    (Korean Society for the Study of Obesity, 2022) Thoppil, Joby J.; Stewart, Lauren K.; Pung, Leland; Nordenholz, Kristen E.; Camargo, Carlos A., Jr.; Courtney, D. Mark; Kline, Jeffrey A.; RECOVER Network; Emergency Medicine, School of Medicine
    Background: Increased body mass index (BMI) and metabolic syndrome (MetS) have been associated with adverse outcomes in viral syndromes. We sought to examine associations of increased BMI and MetS on several clinical outcomes in patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: The registry of suspected COVID-19 in emergency care (RECOVER) is an observational study of SARS-CoV-2-tested patients (n=27,051) across 155 United States emergency departments (EDs). We used multivariable logistic regression to test for associations of several predictor variables with various clinical outcomes. Results: We found that a BMI ≥30 kg/m2 increased odds of SARS-CoV-2 test positivity (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.23-1.38), while MetS reduced odds of testing positive for SARS-CoV-2 (OR, 0.76; 95% CI, 0.71-0.82). Adjusted multivariable analysis found that MetS was significantly associated with the need for admission (OR, 2.11; 95% CI, 1.89-2.37), intensive care unit (ICU) care (OR, 1.58; 95% CI, 1.40-1.78), intubation (OR, 1.46; 95% CI, 1.28-1.66), mortality (OR, 1.29; 95% CI, 1.13-1.48), and venous thromboembolism (OR, 1.51; 95% CI, 1.07-2.13) in SARS-CoV-2-positive patients. Similarly, BMI ≥40 kg/m2 was significantly associated with ICU care (OR, 1.97; 95% CI, 1.65-2.35), intubation (OR, 2.69; 95% CI, 2.22-3.26), and mortality (OR, 1.50; 95% CI, 1.22-1.84). Conclusion: In this large nationwide sample of ED patients, we report a significant association of both high BMI and composite MetS with poor outcomes in SARS-CoV-2-positive patients. Findings suggest that composite MetS profile may be a more universal predictor of adverse disease outcomes, while the impact of BMI is more heavily modulated by SARS-CoV-2 status.
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    Multi-Center Study of Outcomes Among Persons with HIV who Presented to US Emergency Departments with suspected SARS-CoV-2
    (Wolters Kluwer, 2021-08-31) Bennett, Christopher L.; Ogele, Emmanuel; Pettit, Nicholas R.; Bischof, Jason J.; Meng, Tong; Govindarajan, Prasanthi; Camargo, Carlos A., Jr.; Nordenholz, Kristen; Kline, Jeffrey A.; Emergency Medicine, School of Medicine
    Background: There is a need to characterize patients with HIV with suspected severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2). Setting: Multicenter registry of patients from 116 emergency departments in 27 US states. Methods: Planned secondary analysis of patients with suspected SARS-CoV-2, with (n=415) and without (n=25,306) HIV. Descriptive statistics were used to compare patient information and clinical characteristics by SARS-CoV-2 and HIV status. Unadjusted and multivariable models were used to explore factors associated with death, intubation, and hospital length of stay. Kaplan-Meier curves were used to estimate survival by SARS-CoV-2 and HIV infection status. Results: Patients with both SARS-CoV-2 and HIV and patients with SARS-CoV-2 but without HIV had similar admission rates (62.7% versus 58.6%, p=0.24), hospitalization characteristics (e.g. rates of admission to the intensive care unit from the ED [5.0% versus 6.3%, p=0.45] and intubation [10% versus 13.3%, p=0.17]), and rates of death (13.9% versus 15.1%, p=0.65). They also had a similar cumulative risk of death (log-rank p=0.72). However, patients with both HIV and SARS-CoV-2 infections compared to patients with HIV but without SAR-CoV-2 had worsened outcomes, including increased mortality (13.9% versus 5.1%, p<0.01, log rank p<0.0001) and their deaths occurred sooner (median 11.5 days versus 34 days, p<0.01). Conclusion: Among ED patients with HIV, clinical outcomes associated with SARS-CoV-2 infection are not worse when compared to patients without HIV, but SARS-CoV-2 infection increased risk of death in patients with HIV.