Browsing by Subject "Incidence"
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Item Changes in insulin sensitivity over time and associated factors in HIV-infected adolescents(Lippincott, Williams & Wilkins, 2018-03-13) Geffner, Mitchell E.; Patel, Kunjal; Jacobson, Denise L.; Wu, Julia; Miller, Tracie L.; Hazra, Rohan; Gerschenson, Mariana; Sharma, Tanvi; Silio, Margarita; Jao, Jennifer; Takemoto, Jody K.; Van Dyke, Russell B.; Dimeglio, Linda A.; Pediatric HIV/AIDS Cohort Study (PHACS); Pediatrics, School of MedicineOBJECTIVE: To compare prevalence of insulin resistance between perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, but uninfected adolescents (PHEU), determine incidence of and contributory factors to new and resolved cases of insulin resistance in PHIV+, and evaluate glucose metabolism. DESIGN: Cross-sectional design for comparison of prevalence among PHIV+ and PHEU. Longitudinal design for incidence and resolution of insulin resistance among PHIV+ at risk for these outcomes. METHODS: The source population was adolescents from pediatric HIV clinics in the United States and Puerto Rico participating in the Pediatric HIV/AIDS Cohort Study, an ongoing prospective cohort study designed to evaluate impact of HIV infection and its treatment on multiple domains in preadolescents and adolescents. Insulin resistance was assessed by homeostatic model assessment of insulin resistance. Those with incident insulin resistance underwent 2-h oral glucose tolerance test and HbA1c. Baseline demographic, metabolic, and HIV-specific variables were evaluated for association with incident or resolved insulin resistance. RESULTS: Unadjusted prevalence of insulin resistance in PHIV+ was 27.3 versus 34.1% in PHEU. After adjustment for Tanner stage, age, sex, and race/ethnicity, there was no significant difference between groups. Factors positively associated with developing insulin resistance included female sex, higher BMI z score, and higher waist circumference; those associated with resolving insulin resistance included male sex and lower BMI z score. CONCLUSION: Prevalence of insulin resistance in PHIV+ and PHEU was substantially higher than that reported in HIV-uninfected nonoverweight youth, but similar to that in HIV-uninfected obese youth. Factors associated with incident or resolved insulin resistance among PHIV+ were similar to those reported in HIV-negative obese youth. However, a contributory role of HIV infection and/or its treatment to the incident risk of insulin resistance cannot be excluded.Item Citrus Consumption and Risk of Non-Melanoma Skin Cancer in the UK Biobank(Taylor & Francis, 2022) Marley, Andrew R.; Li, Ming; Champion, Victoria L.; Song, Yiqing; Han, Jiali; Li, Xin; Epidemiology, School of Public HealthBackground: Non-melanoma skin cancer (NMSC) incidence has been dramatically increasing worldwide. Psoralen, a known photocarcinogen, is naturally abundant in citrus products, leading to the hypothesis that high citrus consumption may increase NMSC risk. Methods: We fitted age- and multivariable-adjusted logistic regression models to evaluate the association between citrus consumption and NMSC risk among 197,372 UKBB participants. A total of 9,613 NMSC cases were identified using International Classification of Disease 10 codes. Citrus consumption data were collected via five rounds of 24-hour recall questionnaires. Results: We found no association between high total citrus consumption and NMSC risk, although a slightly elevated NMSC risk was observed among participants who consumed >0 to half a serving of total citrus per day (OR [95% CI] = 1.08 [1.01-1.16]). There was no association between individual citrus products and NMSC risk. Conclusion: High citrus consumption was not associated with an increased risk of NMSC in our UKBB sample. Further studies are needed to clarify these associations. Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1952439 .Item Dementia incidence declined in African-Americans but not in Yoruba(Elsevier, 2016-03) Gao, Sujuan; Ogunniyi, Adesola; Hall, Kathleen S.; Baiyewu, Olesegun; Unverzagt, Frederick W.; Lane, Kathleen A.; Murrell, Jill R.; Gureje, Oye; Hendrie, Hugh C.; Department of Biostatistics, Richard M. Fairbanks School of Public HealthINTRODUCTION: To compare dementia incidence of African-American and Yoruba cohorts aged ≥70 years enrolled in 1992 and 2001. METHODS: African-Americans residing in Indianapolis and Yoruba in Ibadan, Nigeria without dementia were enrolled in 1992 and 2001 and evaluated every 2-3 years until 2009. The cohorts consist of 1440 African-Americans, 1774 Yoruba in 1992 and 1835 African-Americans and 1895 Yoruba in the 2001 cohorts aged ≥70 years. RESULTS: In African-Americans, dementia and Alzheimer's disease (AD) incidence rates were significantly lower in 2001 than 1992 for all age groups except the oldest group. The overall standardized annual dementia incidence rates were 3.6% (95% confidence interval [CI], 3.2%-4.1%) in the 1992 cohort and 1.4% (95% CI, 1.2%-1.7%) in the 2001 cohort. There was no significant difference in dementia or AD incidence between the Yoruba cohorts. DISCUSSION: Future research is needed to explore the reasons for the differential changes in incidence rates in these two populations.Item Epidemiology of National Collegiate Athletic Association Women's Gymnastics Injuries, 2009-2010 Through 2013-2014(National Athletic Trainers' Association, 2015-08) Kerr, Zachary Y.; Hayden, Ross; Barr, Megan; Klossner, David A.; Dompier, Thomas P.; School Of Social SciencesContext Recent injury-surveillance data for collegiate-level women's gymnastics are limited. In addition, researchers have not captured non–time-loss injuries (ie, injuries resulting in restriction of participation <1 day). Objective To describe the epidemiology of National Collegiate Athletic Association (NCAA) women's gymnastics injuries during the 2009–2010 through 2013–2014 academic years. Design Descriptive epidemiology study. Setting Aggregate injury and exposure data collected from 11 women's gymnastics programs providing 28 seasons of data. Patients or Other Participants Collegiate student-athletes participating in women's gymnastics during the 2009–2010 through 2013–2014 academic years. Intervention(s) Women's gymnastics data from the NCAA Injury Surveillance Program (ISP) during the 2009–2010 through 2013–2014 academic years were analyzed. Main Outcome Measure(s) Injury rates; injury rate ratios; injury proportions by body site, diagnosis, and apparatus; and injury proportion ratios were reported with 95% confidence intervals (CIs). Results The ISP captured 418 women's gymnastics injuries, a rate of 9.22/1000 athlete-exposures (AEs; 95% CI = 8.33, 10.10). The competition injury rate (14.49/1000 AEs) was 1.67 times the practice injury rate (8.69/1000 AEs; 95% CI = 1.27, 2.19). When considering time-loss injuries only, the injury rate during this study period (3.62/1000 AEs) was lower than rates reported in earlier NCAA ISP surveillance data. Commonly injured body sites were the ankle (17.9%, n = 75), lower leg/Achilles tendon (13.6%, n = 57), trunk (13.4%, n = 56), and foot (12.4%, n = 52). Common diagnoses were ligament sprain (20.3%, n = 85) and muscle/tendon strain (18.7%, n = 78). Overall, 12.4% (n = 52) of injuries resulted in time loss of more than 3 weeks. Of the 291 injuries reported while a student-athlete used an apparatus (69.6%), most occurred during the floor exercise (41.9%, n = 122) and on the uneven bars (28.2%, n = 82). Conclusions We observed a lower time-loss injury rate for women's gymnastics than shown in earlier NCAA ISP surveillance data. Safety initiatives in women's gymnastics, such as “sting mats,” padded equipment, and a redesigned vault table, may have contributed to minimizing the frequency and severity of injury.Item Heart Failure Epidemiology and Outcomes Statistics: A Report of the Heart Failure Society of America(Elsevier, 2023) Bozkurt, Biykem; Ahmad, Tariq; Alexander, Kevin M.; Baker, William L.; Bosak, Kelly; Breathett, Khadijah; Fonarow, Gregg C.; Heidenreich, Paul; Ho, Jennifer E.; Hsich, Eileen; Ibrahim, Nasrien E.; Jones, Lenette M.; Khan, Sadiya S.; Khazanie, Prateeti; Koelling, Todd; Krumholz, Harlan M.; Khush, Kiran K.; Lee, Christopher; Morris, Alanna A.; Page, Robert L., II; Pandey, Ambarish; Piano, Mariann R.; Stehlik, Josef; Stevenson, Lynne Warner; Teerlink, John R.; Vaduganathan, Muthiah; Ziaeian, Boback; Writing Committee Members; Medicine, School of MedicineItem Incidence and risk factors for carbon monoxide poisoning in an emergency department in Nepal(Taylor & Francis, 2022) Acharya, Samita Pant; Purpura, Andrea; Kao, Louise; House, Darlene R.; Emergency Medicine, School of MedicineIncidence of carbon monoxide (CO) poisoning in Nepal has not been studied. The objective of this study was to evaluate baseline carboxyhemoglobin (COHb) concentrations, population risk factors, and incidence of CO poisoning at a single hospital in Nepal. This was a prospective, observational study of patients presenting to Patan Hospital Emergency Department from April 2019 to March 2020. Demographics, risk factors for CO poisoning, symptoms, and clinical pretest probability of CO poisoning was documented. COHb concentration was obtained using a noninvasive co-oximeter. Significant CO exposure was defined as COHb concentration > 10%. CO poisoning was defined as COHb > 10% coupled with symptoms. Of 1,040 patients, 745 patients had a recordable COHb concentration. Median age was 40 years (IQR 33) with 407 (55%) females. Average COHb was 7.2%. Warm months were associated with higher COHb concentrations (8.1% vs 6.0%, p < 0.05). Firewood use had higher COHb concentrations compared to gas heating (8.6% vs 7.0%, p < 0.05). Overall, 228 (31%) patients had a COHb concentration > 10% indicating significant CO exposure. Sixteen patients had CO poisoning. We found a significant baseline incidence of COHb > 10% (31%) in patients presenting to a hospital in Nepal. Risk factors for higher baseline COHb concentrations included warm months and cooking with firewood.Item Incidence Trends, Clinicopathologic Characteristics, and Overall Survival Prediction in Retinoblastoma Children: SEER Prognostic Nomogram Analysis(Oxford University Press, 2024) Guo, Xiaohong; Wang, Li; Beeraka, Narasimha M.; Liu, Chunying; Zhao, Xiang; Zhou, Runze; Yu, Huiming; Fan, Ruitai; Liu, Junqi; Pediatrics, School of MedicineBackground: Retinoblastoma is the most common intraocular malignant tumor occurring among children, with an incidence rate of 1/15 000. This study built a joinpoint regression model to assess the incidence trend of retinoblastoma from 2004 to 2015 and constructed a nomogram to predict the overall survival (OS) in children. Materials and methods: Patients less than 19 years diagnosed with retinoblastoma from 2004 to 2015 were selected from the SEER database. Joinpoint regression analysis (version 4.9.0.0) was performed to evaluate the trends in retinoblastoma incidence rates from 2004 to 2015. Cox Regression Analysis was applied to investigate prognostic risk factors that influence OS. Results: Joinpoint regression revealed that retinoblastoma incidence exhibited no significant increase or decrease from 2004 to 2015. As per the multiple Cox regression, tumor size, laterality, and residence (rural-urban continuum code) were correlated with OS and were used to construct a nomogram. The nomogram exhibited a good C-index of 0.71 (95% CI, 0.63 to 0.79), and the calibration curve for survival probability demonstrated that the predictions corresponded well with actual observations. Conclusions and relevance: A prognostic nomogram integrating the risk factors for retinoblastoma was constructed to provide comparatively accurate individual survival predictions. If validated, this type of assessment could be used to guide therapy in patients with retinoblastoma.Item Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication(Journal of Rheumatology, 2021) Kurmann, Reto D.; El-Am, Edward A.; Radwan, Yasser A.; Sandhu, Avneek S.; Crowson, Cynthia S.; Matteson, Eric L.; Warrington, Kenneth J.; Mankad, Rekha; Makol, Ashima; Medicine, School of MedicineObjective: Cardiac involvement is a poor prognostic marker in systemic sclerosis (SSc). While diastolic dysfunction, myocardial fibrosis, and arrhythmias are traditionally considered features of primary cardiac involvement in SSc, the incidence of valvular heart disease (VHD) is not well reported. Our objective was to examine the prevalence of VHD at the time of SSc diagnosis and incidence of VHD during follow-up compared to non-SSc subjects. Methods: Medical records of patients with suspicion of SSc were reviewed to identify incident cases. SSc subjects were matched 1:2 by age and sex to non-SSc subjects. Results: The study included 78 incident SSc cases and 156 non-SSc comparators (56 yrs [± 15.7], 91% female). A nearly 4-fold increase in the prevalence of moderate/severe VHD prior to SSc diagnosis compared to non-SSc subjects (6% vs 0%; P = 0.004) was identified. During follow-up, 18 SSc and 12 non-SSc patients developed moderate/severe VHD. The cumulative incidence of VHD at 10 years after SSc incidence/index was 17.9% (95% CI 10.7-29.9) in patients with SSc compared with 2.3% (95% CI 0.7-7.0) in non-SSc subjects (HR 4.23, 95% CI 2.03-8.83). Coronary artery disease was the only significant risk factor for VHD. Conclusion: Patients with SSc have a 4-fold increase in the prevalence of moderate/severe VHD at diagnosis compared to non-SSc patients. They also have a 4-fold increased risk of developing moderate/severe VHD after diagnosis of SSc. Aortic stenosis and mitral regurgitation have a much higher prevalence in patients with SSc, besides secondary tricuspid regurgitation. Underlying mechanisms for this association require further elucidation.Item The National Athletic Treatment, Injury and Outcomes Network (NATION): Methods of the Surveillance Program, 2011-2012 Through 2013-2014(National Athletic Trainers' Association, 2015-08) Dompier, Thomas P.; Marshall, Stephen W.; Kerr, Zachary Y.; Hayden, Ross; Department of Epidemiology, Richard M. Fairbanks School of Public HealthCONTEXT: Previous epidemiologic researchers have examined time-loss (TL) injuries in high school student-athletes, but little is known about the frequency of non-time-loss (NTL) injuries in these athletes. OBJECTIVE: To describe the methods of the National Athletic Treatment, Injury and Outcomes Network (NATION) Surveillance Program and provide descriptive epidemiology of TL and NTL injuries across athletes in 27 high school sports. DESIGN: Descriptive epidemiology study. SETTING: Aggregate injury and exposure data collected from 147 high schools in 26 states. PATIENTS OR OTHER PARTICIPANTS: High school student-athletes participating in 13 boys' sports and 14 girls' sports during the 2011-2012 through 2013-2014 academic years. MAIN OUTCOME MEASURE(S): Athletic trainers documented injuries and exposures using commercially available injury-tracking software packages. Standard injury-tracking software was modified by the software vendors to conform to the surveillance needs of this project. The modified software exported a set of common data elements, stripped of personally identifiable information, to a centralized automated verification and validation system before they were included in the centralized research database. Dependent measures were injury and exposure frequencies and injury rates with 95% confidence intervals stratified by sport, sex, and injury type (TL or NTL). RESULTS: Over the 3-year period, a total of 2337 team seasons across 27 sports resulted in 47 014 injuries and 5 146 355 athlete-exposures. The NTL injuries accounted for 38 765 (82.45%) and TL injuries for 8249 (17.55%) of the total. CONCLUSIONS: The NTL injuries accounted for a substantial amount of the total number of injuries sustained by high school student-athletes. This project demonstrates the feasibility of creating large-scale injury surveillance systems using commercially available injury-tracking software.Item Parathyroid Carcinoma: Incidence, Survival Analysis, and Management: A Study from the SEER Database and Insights into Future Therapeutic Perspectives(MDPI, 2022-03-10) Ullah, Asad; Khan, Jaffar; Waheed, Abdul; Sharma, Nitasha; Pryor, Elizabeth K.; Stumpe, Tanner R.; Velasquez Zarate, Luis; Cason, Frederick D.; Kumar, Suresh; Misra, Subhasis; Kavuri, Sravan; Mesa, Hector; Roper, Nitin; Foroutan, Shahin; Karki, Nabin Raj; Del Rivero, Jaydira; Simonds, William F.; Karim, Nagla Abdel; Pathology and Laboratory Medicine, School of MedicineIntroduction: Parathyroid carcinoma (PC) is an extremely rare entity, with a frequency of 0.005% of all malignancies. Most data related to this rare disease are limited to case series and a few database studies. We present a large database study that aims to investigate the demographic, clinical, and pathological factors, prognosis, and survival of PC. Methods: Data of parathyroid carcinoma were extracted from the Surveillance, Epidemiology, and End Results (SEER) diagnosed between 1975 and 2016. Results: PC had a slightly higher incidence in men (52.2%, p < 0.005), the majority of cases affected Caucasians (75.4%, p < 0.005), and the mean age at diagnosis was 62 years. Histologically, 99.7% were adenocarcinomas not otherwise specified (p < 0.005), well-differentiated (p < 0.005), and 2−4 cm (p < 0.001) in size among the patients with available data. In cases with staging provided, most PC were organ-confined (36.8%, p < 0.001). Lymph nodes were positive in 25.2% of cases where lymph node status was reported. The main treatment modality was surgery (97.2%), followed by radiation alone (2%), and very few received chemotherapy alone (0.8%), p < 0.005. Five-year follow-up was available for 82.7% of the cases. Those who underwent surgery only or radiation alone had 5-year survivals of 83.8% and 72.2%, respectively (p < 0.037). Multivariable analysis identified tumor size >4 cm, age > 40 years, male sex, Caucasian race, distant spread, and poorly differentiated grade as independent risk factors for mortality (p < 0.001). Conclusion: PC is a very rare tumor mostly affecting Caucasian individuals in the fifth decade. Older age, poor histologic differentiation, and distant metastasis are associated with a worse prognosis. Surgical resection offers the best survival outcome. To better understand the pathogenesis and factors affecting survival, all PC patients should be enrolled in national and international registries.