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Lee E, Piñeros J, Williams LD, Mackesy-Amiti ME, Molina Y, Boodram B. Network ethnic homophily and injection equipment sharing among Latinx and White non-Latinx people who inject drugs. J Ethn Subst Abuse 2023:1-20. [PMID: 36853193 PMCID: PMC10460831 DOI: 10.1080/15332640.2023.2181259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Latinx people who inject drugs (PWID) are less likely to engage in injection equipment sharing, but are more vulnerable to injection drug use (IDU)-related morbidity and mortality than Whites. Identifying subgroups of Latinx PWID who do engage in equipment sharing and likely bear the brunt of this health burden is a priority. Ethnic disparities may reflect contextual drivers, including injection networks. Latinx PWID with low ethnic homophily (the proportion of individuals with the same ethnic background) may be more likely to share equipment due to forced distancing from health-protective ethnocultural resources and power imbalances within injection networks. The current study offers a framework and examines how associations between network ethnic homophily and injection equipment sharing differ among 74 Latinx and 170 non-Latinx White PWID in the Chicagoland area (N = 244). Latinx had less homophilous than non-Latinx Whites (p <.001). Ethnic homophily was protective for equipment sharing among Latinx (OR = 0.17, 95%CI [0.77, 0.04], p = .02), but not non-Latinx Whites (OR = 1.66, 95%CI [0.40, 6.93], p = .49). Our findings implicate the need for targeted cultured interventions that focus on Latinx PWID who are more vulnerable to morbidity and mortality, potentially due to less access to ethnic peers.
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Affiliation(s)
- Eunhye Lee
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, United States
| | - Juliet Piñeros
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago
| | - Leslie D. Williams
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, United States
| | - Mary-Ellen Mackesy-Amiti
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, United States
| | - Yamilé Molina
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, United States
| | - Basmattee Boodram
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, United States
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Crocker RM, Morrill KE, Villavicencio EA, Garcia DO. How Mexicans' Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care. J Transcult Nurs 2022; 33:615-623. [PMID: 35684997 DOI: 10.1177/10436596221101923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION This article aims to increase understanding of how Mexican immigrants respond to learning about non-alcoholic fatty liver disease (NAFLD), a spectrum disease with a heavy burden among Mexican-origin people. METHODOLOGY This article presents findings from qualitative interviews (n = 26) that formed part of a mixed-methods study of foreign-born Mexican immigrants carried out in 2019 to 2020 in southern Arizona to assess NAFLD awareness. RESULTS We documented common experiences of surprise, fear, and hope during study participation, all of which motivated research participants to reduce their NAFLD risk by seeking additional information, sharing it with others, and making lifestyle changes. DISCUSSION Understanding how these emotional experiences are tied to cultural and historical factors-including Mexico's high rates of liver disease, participant's limited access to health care, and the ability to address the NAFLD risk with lifestyle changes-may promote the development of more effective and culturally congruent care in this population.
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Affiliation(s)
- Rebecca M Crocker
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | | | - Edgar A Villavicencio
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - David O Garcia
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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Villavicencio EA, Crocker RM, Garcia DO. A Qualitative Analysis of Mexican-Origin Men's Knowledge and Cultural Attitudes Toward Non-Alcoholic Fatty Liver Disease and Interest in Risk Reduction. Am J Mens Health 2021; 15:15579883211063335. [PMID: 34872379 PMCID: PMC8655456 DOI: 10.1177/15579883211063335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Mexican-origin men are at increased risk of developing non-alcoholic fatty liver disease (NAFLD). The purpose of this qualitative research was to assess Mexican-origin men’s knowledge and cultural attitudes toward NAFLD and their interest in risk reduction. Semi-structured interviews were conducted with 11 Spanish-speaking Mexican-origin men who were considered high-risk of having NAFLD according to transient elastography (FibroScan®) continuous attenuation parameter (CAP) scores (≥280). Audio recordings of these interviews were transcribed and interpreted in their respective language to facilitate data analysis using NVivo 12. A thematic codebook was developed, from which the research team identified emerging themes. Findings demonstrated limited knowledge about NAFLD and in general chronic liver disease among Mexican-origin men. Cultural attitudes appeared to both enhance and mitigate their perceived risk for NAFLD. Interviews also revealed high interest levels for reducing NAFLD risk, with family and loved ones acting as the main motivators for engagement in healthier behaviors. Inclination toward family-based interventions was reported as a subject of interest for this high-risk population. This qualitative study suggests that the development of a NAFLD-specific intervention approach for Mexican-origin men may be feasible and should consider a familial and cultural context centered in improving lifestyle health behaviors.
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Affiliation(s)
- Edgar A Villavicencio
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Rebecca M Crocker
- Center for Border Health Disparities, Health Sciences, The University of Arizona, Tucson, AZ, USA
| | - David O Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
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Morrill KE, Crocker RM, Hingle MD, Thomson CA, Garcia DO. Awareness, Knowledge, and Misperceptions Related to Nonalcoholic Fatty Liver Disease in a Community Sample of Mexican-Origin Women: A Mixed Methods Study. Front Public Health 2021; 9:626428. [PMID: 34485209 PMCID: PMC8415027 DOI: 10.3389/fpubh.2021.626428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/16/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction: Mexican-origin women suffer disproportionate rates of nonalcoholic fatty liver disease (NAFLD) and research on how to tailor NAFLD treatment interventions for this population is lacking. Objectives: The purpose of this study was to assess awareness, knowledge, perceptions, and information sources related to NAFLD in a community-based sample of Mexican-origin women. Methods: This study employed a convergent parallel mixed-methods approach and consisted of a brief questionnaire (n = 194) and interviews (n = 26) among Mexican-origin women recruited from community-based settings including health fairs, churches, and community events. Participants were eligible if they identified as Mexican-origin, had a BMI ≥ 25 kg/m2, were 18-64 years of age, had the ability to speak, read, and write in English and/or Spanish, and provided informed consent. A purposeful sampling approach was used to recruit a subset of women (n = 26) with confirmed liver steatosis indicative of NAFLD (controlled attenuation parameter ≥280 dB/m) who completed the questionnaire. The twenty-six participants then completed one on one, in-depth semi-structured interviews to ascertain their knowledge and understanding of NAFLD. Results: Qualitative findings revealed low awareness of risk factors for liver disease, NAFLD specifically. Knowledge of liver disease tended to center around cirrhosis, a condition many participants reported was prevalent in their families. Quantitative and qualitative findings both found information sources for NAFLD and liver disease to be predominantly friends, family, and media. Interviews revealed a misperception related to NAFLD risk that liver disease was only caused by high alcohol intake. Conclusion: Low levels of NAFLD awareness and knowledge warrant the need for greater efforts to educate the general population, perhaps by integrating NAFLD education into existing type 2 diabetes educational campaigns and prevention interventions. Additionally, further elicitation research conducted in Mexican-origin adults is needed to elucidate key factors within behavioral-theory constructs that can be targeted in future interventions tailored to this unique population.
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Affiliation(s)
- Kristin E Morrill
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - Rebecca M Crocker
- Center for Border Health Disparities, Health Sciences, University of Arizona, Tucson, AZ, United States
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - David O Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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Nguyen MP, Amoon AT, Lee L, Chiang V, Nham K, Sun AQ, Ji M, Sundin P, Bastani R, Flores YN. Health Literacy, Knowledge, and Risk Factors for Fatty Liver Disease among Asian American and Pacific Islanders and Latinos in Los Angeles. Asian Pac J Cancer Prev 2021; 22:1737-1744. [PMID: 34181328 PMCID: PMC8418836 DOI: 10.31557/apjcp.2021.22.6.1737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 06/14/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Fatty liver disease (FLD) is associated with increased risk for hepatocellular carcinoma (HCC) and is associated with rising rates of diabetes and obesity. The prevalence of FLD is rising among Asian American and Pacific Islanders (AAPIs) and Latinos. This study examined health literacy, knowledge, and risk factors for FLD among AAPIs and Latinos in Los Angeles. METHODS Data from in-person interviews and clinical measures (body mass index (BMI), body fat percentage, and blood pressure) were obtained from adults aged 18-82 years at four health fairs from November 2018 to March 2019. Interviews assessed knowledge about FLD, access to health resources, and satisfaction with current physician. Correct responses to knowledge questions were summed to generate a FLD knowledge score. Linear regression models were used to examine the association between knowledge score and age, sex, and race/ethnicity. RESULTS A total of 102 subjects were AAPI and 33 were Latino. Over 65% of participants had heard of FLD but demonstrated limited knowledge about FLD. Only 24% of subjects reported receiving FLD resources in their preferred language. Most subjects failed to identify several risk factors and key symptoms of FLD. Mean knowledge score for subjects who had heard of FLD was 7.58 (95% CI 7.15-8.01) out of a possible 16 points, and for those who had not who had not heard of FLD it was 5.71 (5.00-6.42) (p <0.0001). CONCLUSIONS A lack of culturally competent resources and effective communication strategies between physicians and patients regarding FLD contributes to a lower awareness about the increased risk of FLD among AAPIs and Latinos. Future studies should investigate optimal methods to educate these communities about FLD and its associations with HCC.
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Affiliation(s)
- Minh P Nguyen
- University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
| | - Aryana T Amoon
- UCLA Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, United States.
| | - Lucia Lee
- University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
| | - Vincent Chiang
- University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
| | - Kourtney Nham
- University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
| | - Aleck Q. Sun
- University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
| | - Matthew Ji
- University of California, Los Angeles (UCLA), Los Angeles, CA, United States.
| | - Phillip Sundin
- UCLA Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, United States.
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, United States.
| | - Roshan Bastani
- UCLA Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, United States.
- UCLA Department of Health Policy and Management and UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Los Angeles, CA, United States.
| | - Yvonne N Flores
- UCLA Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, United States.
- UCLA Department of Health Policy and Management and UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Los Angeles, CA, United States.
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, CP México, United States.
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Roesch-Dietlen F, González-Santes M, Sánchez-Maza Y, Díaz-Roesch F, Cano-Contreras A, Amieva-Balmori M, García-Zermeño K, Salgado-Vergara L, Remes-Troche J, Ortigoza-Gutiérrez S. Influence of socioeconomic and cultural factors in the etiology of cirrhosis of the liver. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2021. [DOI: 10.1016/j.rgmxen.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Roesch-Dietlen F, González-Santes M, Sánchez-Maza YJ, Díaz-Roesch F, Cano-Contreras AD, Amieva-Balmori M, García-Zermeño KR, Salgado-Vergara L, Remes-Troche JM, Ortigoza-Gutiérrez S. Influence of socioeconomic and cultural factors in the etiology of cirrhosis of the liver. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2020; 86:28-35. [PMID: 32345507 DOI: 10.1016/j.rgmx.2020.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Cirrhosis of the liver is a serious public health problem worldwide, with regional variations determined by cultural factors and economic development. AIM To know the characteristics of the social, cultural, and economic factors of the patients with cirrhosis of the liver in Veracruz. MATERIALS AND METHODS A multicenter, retrolective, relational research study was conducted on patients with cirrhosis of the liver at five healthcare institutions in Veracruz. The variables analyzed were etiology, age, sex, civil status, educational level, occupation, and income. Descriptive and inferential statistics were utilized, and statistical significance was set at a P<.05. The Windows IBM-SPSS version 25.0 program was employed. RESULTS A total of 182 case records of patients with cirrhosis of the liver were included. The etiologic factors were chronic alcohol consumption (47.8%), viral disease (28.5%), nonalcoholic fatty liver disease (NAFLD) (8.79%), autoimmune liver disease (4.4%), cholestasis (1.64%), and cryptogenic liver disease (8.8%). Mean patient age was 66.14±13.91, with a predominance of men (58.79%). In comparing the socioeconomic and cultural factors related to etiology, secondary and tertiary education and singleness were statistically significant in male alcoholics (P<.05), viral diseases and NAFLD were significantly associated with women with no income (P<.05), cryptogenic liver disease was significantly associated with women (P<.05), and cholestasis and autoimmune liver disease were not significantly associated with any of the factors. CONCLUSIONS The study results revealed the influence of socioeconomic and cultural factors related to the different causes of cirrhosis of the liver in our environment.
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Affiliation(s)
- F Roesch-Dietlen
- Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Ver., México.
| | - M González-Santes
- Facultad de Bioanálisis, Universidad Veracruzana, Veracruz, Ver., México
| | - Y J Sánchez-Maza
- Departamento de Anestesiología, Hospital General Dr. Eduardo Liceaga, Secretaría de Salud, Ciudad de México, México
| | - F Díaz-Roesch
- Departamento de Gastroenterología, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Ver., México
| | - A D Cano-Contreras
- Departamento de Gastroenterología, Hospital Juárez de México, Ciudad de México, México
| | - M Amieva-Balmori
- Laboratorio de Fisiología Digestiva y Motilidad, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Ver., México
| | - K R García-Zermeño
- Laboratorio de Fisiología Digestiva y Motilidad, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Ver., México
| | - L Salgado-Vergara
- Servicio Social, Facultad de Medicina, Universidad Veracruzana, Veracruz, Ver., México
| | - J M Remes-Troche
- Laboratorio de Fisiología Digestiva y Motilidad, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, Veracruz, Ver., México
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Bai Z, Li B, Lin S, Liu B, Li Y, Zhu Q, Wu Y, Yang Y, Tang S, Meng F, Chen Y, Yuan S, Shao L, Qi X. Development and Validation of CAGIB Score for Evaluating the Prognosis of Cirrhosis with Acute Gastrointestinal Bleeding: A Retrospective Multicenter Study. Adv Ther 2019; 36:3211-3220. [PMID: 31512140 PMCID: PMC6822790 DOI: 10.1007/s12325-019-01083-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Acute gastrointestinal bleeding (GIB) is a major cause of death in liver cirrhosis. This multicenter study aims to develop and validate a novel and easy-to-access model for predicting the prognosis of patients with cirrhosis and acute GIB. METHODS Patients with cirrhosis and acute GIB were enrolled and randomly divided into the training (n = 865) and validation (n = 817) cohorts. In the training cohort, the independent predictors for in-hospital death were identified by logistic regression analyses, and then a new prognostic model (i.e., CAGIB score) was established. Area under curve (AUC) of CAGIB score was calculated by receiver operating characteristic curve analysis and compared with Child-Pugh, model for end-stage liver disease (MELD), MELD-Na, and neutrophil-lymphocyte ratio (NLR) scores. RESULTS In the training cohort, hepatocellular carcinoma (HCC), diabetes, total bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ALT), and serum creatinine (Scr) were independent predictors of in-hospital death. CAGIB score = diabetes (yes = 1, no = 0) × 1.040 + HCC (yes = 1, no = 0) × 0.974 + TBIL (μmol/L) × 0.005 - ALB (g/L) × 0.091 + ALT (U/L) × 0.001 + Scr (μmol/L) × 0.012 - 3.964. In the training cohort, the AUC of CAGIB score for predicting in-hospital death was 0.829 (95% CI 0.801-0.854, P < 0.0001), which was higher than that of Child-Pugh (0.762, 95% CI 0.732-0.791), MELD (0.778, 95% CI 0.748-0.806), MELD-Na (0.765, 95% CI 0.735-0.793), and NLR (0.587, 95% CI 0.553-0.620) scores. In the validation cohort, the AUC of CAGIB score (0.714, 95% CI 0.682-0.746, P = 0.0006) remained higher than that of Child-Pugh (0.693, 95% CI 0.659-0.725), MELD (0.662, 95% CI 0.627-0.695), MELD-Na (0.660, 95% CI 0.626-0.694), and NLR (0.538, 95% CI 0.503-0.574) scores. CONCLUSION CAGIB score has a good predictive performance for prognosis of patients with cirrhosis and acute GIB.
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Affiliation(s)
- Zhaohui Bai
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China
| | - Bimin Li
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Su Lin
- Liver Research Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Bang Liu
- Department of Hepatobiliary Disease, 900 Hospital of the Joint Logistics Team (formerly called Fuzhou General Hospital), Fuzhou, China
| | - Yiling Li
- Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qiang Zhu
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Yunhai Wu
- Department of Critical Care Medicine, Sixth People's Hospital of Shenyang, Shenyang, China
| | - Yida Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shanhong Tang
- Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu, China
| | - Fanping Meng
- Department of Biological Therapy, Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Yu Chen
- Difficult and Complicated Liver Diseases and Artificial Liver Center, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Shanshan Yuan
- Department of Gastroenterology, Xi'an Central Hospital, Xi'an, China
| | - Lichun Shao
- Department of Gastroenterology, Air Force Hospital of Northern Theater Command, Shenyang, China
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China.
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Flores YN, Zhang ZF, Bastani R, Leng M, Crespi CM, Ramírez-Palacios P, Stevens H, Salmerón J. Risk factors for liver disease among adults of Mexican descent in the United States and Mexico. World J Gastroenterol 2018; 24:4281-4290. [PMID: 30310261 PMCID: PMC6175761 DOI: 10.3748/wjg.v24.i37.4281] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/01/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the prevalence of chronic liver disease (CLD) risk factors in a representative sample of Mexican-Americans born in the United States (US) or Mexico, to a sample of adults in Mexico.
METHODS Data for Mexican-Americans in the US were obtained from the 1999-2014 National Health and Nutrition Examination Survey (NHANES), which includes persons of Mexican origin living in the US (n = 4274). The NHANES sample was restricted to Mexican-American participants who were 20 years and older, born in the US or Mexico, not pregnant or breastfeeding, and with medical insurance. The data in Mexico were obtained from the 2004-2013 Health Worker Cohort Study in Cuernavaca, Mexico (n = 9485). The following known risk factors for liver disease/cancer were evaluated: elevated aminotransferase levels (elevated alanine aminotransferase was defined as > 40 IU/L for males and females; elevated aspartate aminotransferase was defined as > 40 IU/L for males and females), infection with hepatitis B or hepatitis C, metabolic syndrome, high total cholesterol, diabetes, obesity, abdominal obesity, and heavy alcohol use. The main independent variables for this study classified individuals by country of residence (i.e., Mexico vs the US) and place of birth (i.e., US-born vs Mexico-born). Regression analyses were used to investigate CLD risk factors.
RESULTS After adjusting for socio-demographic characteristics, Mexican-American males were more likely to be obese, diabetic, heavy/binge drinkers or have abdominal obesity than males in Mexico. The adjusted multivariate results for females also indicate that Mexican-American females were significantly more likely to be obese, diabetic, be heavy/binge drinkers or have abdominal obesity than Mexican females. The prevalence ratios and prevalence differences mirror the multivariate analysis findings for the aforementioned risk factors, showing a greater risk among US-born as compared to Mexico-born Mexican-Americans.
CONCLUSION In this study, Mexican-Americans in the US had more risk factors for CLD than their counterparts in Mexico. These findings can be used to design and implement more effective health promotion policies and programs to address the specific factors that put Mexicans at higher risk of developing CLD in both countries.
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Affiliation(s)
- Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, México
- UCLA Department of Health Policy and Management and Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Los Angeles, CA 90095, United States
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, United States
| | - Zuo-Feng Zhang
- UCLA Department of Epidemiology, Fielding School of Public Health, Los Angeles, CA 90095, United States
| | - Roshan Bastani
- UCLA Department of Health Policy and Management and Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Los Angeles, CA 90095, United States
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, United States
| | - Mei Leng
- UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, CA 90095, United States
| | - Catherine M Crespi
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, United States
- UCLA Department of Biostatistics, Fielding School of Public Health, Los Angeles, CA 90095, United States
| | - Paula Ramírez-Palacios
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, México
| | - Heather Stevens
- University of Washington, School of Medicine, Seattle, WA 98195, United States
| | - Jorge Salmerón
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, México
- Universidad Nacional Autónoma de México, Academic Epidemiology Research Unit, Avenida Universidad 3000, Ciudad Universitaria, Coyoacán, Mexico City 04510, México
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos 62100, México
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Elliott JC, Stohl M, Hasin DS. Drinking despite health problems among individuals with liver disease across the United States. Drug Alcohol Depend 2017; 176:28-32. [PMID: 28514693 PMCID: PMC5514837 DOI: 10.1016/j.drugalcdep.2017.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/07/2017] [Accepted: 03/03/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Heavy drinking is harmful for individuals with liver disease. However, some of these individuals drink despite knowledge of the risks. The current study aims to identify factors underlying drinking despite health problems among individuals with liver disease. METHODS The current study utilizes a subsample of individuals reporting past-year liver disease and at least one drink in the past year (n=331), taken from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a large nationally representative survey of the United States. Participants reported on drinking despite health problems, symptoms of psychopathology, and family history of alcohol problems in a cross-sectional survey. RESULTS Drug use disorders (Adjusted Odds Ratio [AOR]=2.68), as well as borderline, antisocial, and schizotypal personality disorders (AORs=2.50-4.10), were associated with increased likelihood of drinking despite health problems among individuals with liver disease, all ps<0.05. Any anxiety disorder trended toward significance (AOR=2.22), p=0.06, but major depressive disorder was not associated with increased risk, (AOR=0.99), ps=0.97. Individuals with a family history of alcohol problems were also more likely to drink despite health problems (AOR=2.79), p<0.05. CONCLUSIONS Several types of psychopathology, as well as a family history of alcohol problems, increased the likelihood of drinking despite health problems among individuals with liver disease. These findings highlight the need to intervene with heavily drinking individuals with liver disease, who may be drinking due to familial risk and/or comorbid psychopathology.
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Affiliation(s)
- Jennifer C Elliott
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, Box 123, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, Box 123, New York, NY 10032, USA.
| | - Malka Stohl
- New York State Psychiatric Institute, 1051 Riverside Drive, Box 123, New York, NY 10032, USA
| | - Deborah S Hasin
- Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, Box 123, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, Box 123, New York, NY 10032, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
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Owiti JA, Greenhalgh T, Sweeney L, Foster GR, Bhui KS. Illness perceptions and explanatory models of viral hepatitis B & C among immigrants and refugees: a narrative systematic review. BMC Public Health 2015; 15:151. [PMID: 25886390 PMCID: PMC4336715 DOI: 10.1186/s12889-015-1476-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 01/27/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hepatitis B and C (HBV, HCV) infections are associated with high morbidity and mortality. Many countries with traditionally low prevalence (such as UK) are now planning interventions (screening, vaccination, and treatment) of high-risk immigrants from countries with high prevalence. This review aimed to synthesise the evidence on immigrants' knowledge of HBV and HCV that might influence the uptake of clinical interventions. The review was also used to inform the design and successful delivery of a randomised controlled trial of targeted screening and treatment. METHODS Five databases (PubMed, CINHAL, SOCIOFILE, PsycINFO & Web of Science) were systematically searched, supplemented by reference tracking, searches of selected journals, and of relevant websites. We aimed to identify qualitative and quantitative studies that investigated knowledge of HBV and HCV among immigrants from high endemic areas to low endemic areas. Evidence, extracted according to a conceptual framework of Kleinman's explanatory model, was subjected to narrative synthesis. We adapted the PEN-3 model to categorise and analyse themes, and recommend strategies for interventions to influence help-seeking behaviour. RESULTS We identified 51 publications including quantitative (n = 39), qualitative (n = 11), and mixed methods (n = 1) designs. Most of the quantitative studies included small samples and had heterogeneous methods and outcomes. The studies mainly concentrated on hepatitis B and ethnic groups of South East Asian immigrants residing in USA, Canada, and Australia. Many immigrants lacked adequate knowledge of aetiology, symptoms, transmission risk factors, prevention strategies, and treatment, of hepatitis HBV and HCV. Ethnicity, gender, better education, higher income, and English proficiency influenced variations in levels and forms of knowledge. CONCLUSION Immigrants are vulnerable to HBV and HCV, and risk life-threatening complications from these infections because of poor knowledge and help-seeking behaviour. Primary studies in this area are extremely diverse and of variable quality precluding meta-analysis. Further research is needed outside North America and Australia.
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Affiliation(s)
- John A Owiti
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Charterhouse Square, Queen Mary University of London, Centre for Psychiatry, EC1M 6BQ, London, UK.
| | - Trisha Greenhalgh
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Centre for Primary Care and Public Health, Yvonne Carter Building, 58 Turner Street, E1 2AB, London, UK.
| | - Lorna Sweeney
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Centre for Primary Care and Public Health, Yvonne Carter Building, 58 Turner Street, E1 2AB, London, UK.
| | - Graham R Foster
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, The Liver Unit, Centre for Digestive Diseases, 4 Newark Street, E1 2AT, London, UK.
| | - Kamaldeep S Bhui
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Charterhouse Square, Queen Mary University of London, Centre for Psychiatry, EC1M 6BQ, London, UK.
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Zhu S, Li Y, Zhang Y, Wang X, Gong L, Han X, Yao L, Lan M, Zhang W. Expression and clinical implications of HAb18G/CD147 in hepatocellular carcinoma. Hepatol Res 2015; 45:97-106. [PMID: 24593119 DOI: 10.1111/hepr.12320] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 02/21/2014] [Accepted: 02/25/2014] [Indexed: 12/20/2022]
Abstract
AIM HAb18G/CD147 is an important factor in invasion and metastasis of hepatocellular carcinoma (HCC). However, the clinical implications of HAb18G/CD147 expression in HCC are still unclear. In this study, we clarify the clinical significance of HAb18G/CD147. We characterize the association between HAb18G/CD147 expression and presentation of fibrosis or chronic hepatitis B, as well as its effect on HCC development. METHODS The expression of HAb18G/CD147 in human hepatocarcinoma cell lines was analyzed by reverse transcription polymerase chain reaction and western blotting. Tumor tissues were obtained from HCC patients who underwent surgical resection between 2002 and 2006. All patients who had received previous therapy were excluded. HCC tissues were analyzed by immunohistochemistry using anti-HAb18G/CD147. RESULTS HAb18G/CD147 was widely expressed in Hep-G2, SMCC-7721 and BEL7402 cell lines, but not expressed in L-02, a human normal hepatic cell line. HAb18G/CD147 was mainly localized to the membrane of tumor cells in 74.0% (37/50) HCC patients. We found that higher HAb18G/CD147 expression and poor tumor differentiation were correlated with patient survival (P = 0.026 and P = 0.014, respectively). Furthermore, the distribution of HAb18G/CD147 was similar to that of hepatitis B virus (HBV) infection, but negatively related to hepatic cirrhosis. CONCLUSION HAb18G/CD147 has shown its potentials in HCC development and patient survival. Moreover, it may also cooperate with chronic HBV infection and cirrhosis during HCC development. Its functions in the two factors may be different. Therefore, HAb18G/CD147 may be a marker for poor prognosis in HCC patients and could be a useful therapeutic target for interfering with or reversing HCC progression.
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Affiliation(s)
- Shaojun Zhu
- Department of Pathology, The Helmholtz Sino-German Research Laboratory for Cancer, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
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Hepatitis and liver disease knowledge and preventive practices among health workers in Mexico: a cross-sectional study. Int J Public Health 2013; 59:381-94. [PMID: 24097058 DOI: 10.1007/s00038-013-0515-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 09/14/2013] [Accepted: 09/16/2013] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To assess the knowledge and preventive practices regarding hepatitis and liver disease among a sample of participants in the Mexican Health Worker Cohort Study. METHODS The study population consisted of 892 participants from Cuernavaca, Mexico. Demographic characteristics, knowledge about hepatitis B, hepatitis C, and liver disease in general, as well as information about prevention practices were obtained from self-reported questionnaires. Participants were grouped into categories that were created using information about their professional background and patient contact status. Knowledge and prevention practices were compared within these categories. RESULTS Inadequate levels of knowledge and preventive practices were found, even within the more highly educated group. Nearly 57 % of the participants had inadequate knowledge about liver disease in general, while 76 and 79 % had inadequate knowledge about Hepatitis B virus (HBV) and Hepatitis C virus (HCV), respectively. For general liver disease, the mean knowledge score increased significantly with education, history of HCV screening, and low alcohol consumption. CONCLUSIONS Health workers should be better educated about hepatitis and liver disease so they can reduce their own risk and share their knowledge of how to prevent liver disease with patients.
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Abstract
Globally, hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection leads to liver fibrosis and cirrhosis, which in turn causes resultant hepatocellular carcinoma (HCC). Frequently, HCC recurs very soon even after a potentially curative treatment such as surgical interference or locoregional ablative therapies. Chronic HBV/HCV infection is often responsible for this recurrence, through secondary carcinogenesis. Antiviral therapy after a curative treatment of HCC plays an important role in preventing or delaying recurrence and improves survival in patients with HBV/HCV infection-related HCC. This article reviews the worldwide epidemiology of HBV/HCV infection, the association of viral infection with HCC, the mechanism of hepatitis virus-related hepatocarcinogenesis, and the paramount importance of antiviral therapy in the management of HCC.
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Abstract
Hispanics/Latinos are the largest and fastest growing major demographic group in the United States, accounting for 16.3% (50.5 million/310 million) of the US population in 2010. In this article, the American Cancer Society updates a previous report on cancer statistics for Hispanics using incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. In 2012, an estimated 112,800 new cases of cancer will be diagnosed and 33,200 cancer deaths will occur among Hispanics. In 2009, the most recent year for which actual data are available, cancer surpassed heart disease as the leading cause of death among Hispanics. Among US Hispanics during the past 10 years of available data (2000-2009), cancer incidence rates declined by 1.7% per year among men and 0.3% per year among women, while cancer death rates declined by 2.3% per year in men and 1.4% per year in women. Hispanics have lower incidence and death rates than non-Hispanic whites for all cancers combined and for the 4 most common cancers (breast, prostate, lung and bronchus, and colorectum). However, Hispanics have higher incidence and mortality rates for cancers of the stomach, liver, uterine cervix, and gallbladder, reflecting greater exposure to cancer-causing infectious agents, lower rates of screening for cervical cancer, differences in lifestyle and dietary patterns, and possibly genetic factors. Strategies for reducing cancer risk among Hispanics include increasing utilization of screening and available vaccines, as well as implementing effective interventions to reduce obesity, alcohol consumption, and tobacco use.
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Affiliation(s)
- Rebecca Siegel
- Surveillance Information, Surveillance Research, American Cancer Society, Atlanta, GA 30303, USA.
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