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Choi BC, Barengo NC, Diaz PA. Public health surveillance and the data, information, knowledge, intelligence and wisdom paradigm. Rev Panam Salud Publica 2024; 48:e9. [PMID: 38464871 PMCID: PMC10921903 DOI: 10.26633/rpsp.2024.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/15/2023] [Indexed: 03/12/2024] Open
Abstract
This article points out deficiencies in present-day definitions of public health surveillance, which include data collection, analysis, interpretation and dissemination, but not public health action. Controlling a public health problem of concern requires a public health response that goes beyond information dissemination. It is undesirable to have public health divided into data generation processes (public health surveillance) and data use processes (public health response), managed by two separate groups (surveillance experts and policy-makers). It is time to rethink the need to modernize the definition of public health surveillance, inspired by the authors' enhanced Data, Information, Knowledge, Intelligence and Wisdom model. Our recommendations include expanding the scope of public health surveillance beyond information dissemination to comprise actionable knowledge (intelligence); mandating surveillance experts to assist policy-makers in making evidence-informed decisions; encouraging surveillance experts to become policy-makers; and incorporating public health literacy training - from data to knowledge to wisdom - into the curricula for all public health professionals. Work on modernizing the scope and definition of public health surveillance will be a good starting point.
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Affiliation(s)
- Bernard C.K. Choi
- Division of Clinical Public HealthDalla Lana School of Public HealthUniversity of TorontoTorontoCanadaDivision of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Noël C. Barengo
- Department of Medical EducationHerbert Wertheim College of MedicineFlorida International UniversityMiamiUnited States of AmericaDepartment of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, United States of America
| | - Paula A. Diaz
- Epidemiology GroupNational School of Public HealthUniversity of AntioquiaMedellínColombiaEpidemiology Group, National School of Public Health, University of Antioquia, Medellín, Colombia
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Alkhatib A, Barengo NC. Editorial: Physical activity, health equity and health-related outcomes, volume II. Front Public Health 2024; 12:1379960. [PMID: 38435284 PMCID: PMC10905956 DOI: 10.3389/fpubh.2024.1379960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Affiliation(s)
- Ahmad Alkhatib
- College of Life Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Noël C. Barengo
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
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Guerra J, Jhon J, Lanza K, Castro G, Barengo NC. The availability between recreational facilities and physical activity of US adolescents. Prev Med Rep 2024; 38:102592. [PMID: 38283963 PMCID: PMC10820262 DOI: 10.1016/j.pmedr.2024.102592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/30/2024] Open
Abstract
Determining the locations where adolescents tend to accumulate greater amounts of physical activity may assist policymakers to address the built environment design and promote PA. This study evaluated the association between the availability of recreational facilities and average minutes of moderate to vigorous physical activity (MVPA) per day of US adolescents in 2017 (n = 1,437). Data for this cross-sectional study were obtained from the 2017 Family Life, Activity, Sun, Health, and Eating study, an internet-based study collecting information on diet and PA of parent and adolescent dyads. Adolescents aged 12-17 from the US were included. Predicted daily minutes of MVPA were calculated. The exposure variables of interest were the availability of school recreational facilities, indoor recreational facilities, playing fields, bike/hiking/walking trails or paths or public parks. Participants were excluded if no information was provided for MVPA or availability of recreational facilities. Unadjusted and adjusted linear regression analysis was used to calculate mean daily minutes of MVPA and their corresponding 95 % confidence intervals. In fully adjusted models, we found statistically significant associations between the type of recreational facility and differences in daily minutes of MVPA for school (p-value < 0.001) and public parks p-value < 0.001), but not for the other recreational facilities. The average daily minutes of MVPA differed by 4.4 min (95 % CI 2.6, 6.2) if participants had school recreational facilities, respectively. School recreational facilities are important for engaging adolescents in PA objectives. Features within school recreational facilities should be studied to further investigate contributions to increased PA levels.
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Affiliation(s)
- Jamee Guerra
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Perú
- Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Johnatan Jhon
- Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Kevin Lanza
- University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Grettel Castro
- Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C. Barengo
- Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
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Black AK, Kahn AE, Lamy C, Warman R, Barengo NC. The association between race and age of diagnosis of retinoblastoma in United States children. J AAPOS 2024; 28:103810. [PMID: 38237725 DOI: 10.1016/j.jaapos.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/29/2023] [Accepted: 11/07/2023] [Indexed: 01/29/2024]
Abstract
PURPOSE To explore the associations between race and retinoblastoma diagnosis in United States children. METHODS In this analytical nonconcurrent cohort study, we used 1988-2018 data from the Surveillance, Epidemiology, and End-Results (SEER) database. Children ages 0-17 with retinoblastoma were included (n = 758); those with missing data were excluded (n = 11; final cohort: n = 747). The exposure variable was race (White, Black, Asian/Pacific Islanders, American Indian/Alaska Native), and the outcome variable was diagnosis of retinoblastoma before versus after 2 years of age. Covariates included sex, rural-urban continuum, ethnicity, decade of diagnosis, and laterality of disease. Unadjusted and adjusted logistic regression analyses were performed to calculate odds ratios and 95% confidence intervals. RESULTS No statistically significant association was found between racial/ethnic groups (OR = 0.61-0.99; P = 0.92) and age at diagnosis (OR = 0.86; P = 0.66). Females were more likely to be diagnosed earlier than males (OR = 0.62; 95% CI, 0.44-0.88; P = 0.042). No association was found between urban versus rural subjects (OR = 1.02; 95% CI, 0.60-1.75) or between decades (OR = 0.81; 95% CI, 0.54-1.22 and OR 0.96; 95% CI, 0.62-1.47). CONCLUSIONS We found no statistically significant difference between racial/ethnic groups for diagnosis of children with retinoblastoma after 2 years of age. Future studies could explore why females are more likely than males to be diagnosed before 2 years of age.
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Affiliation(s)
- Alexander K Black
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida.
| | - Amanda E Kahn
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
| | - Chrisnel Lamy
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
| | - Roberto Warman
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
| | - Noël C Barengo
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida
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Enyeji A, Ibrahimou B, Barengo NC, Ramirez G, Arrieta A. Racial Disparities in Cardiovascular Health Among the Acute Coronary Syndrome Population. Popul Health Manag 2023; 26:378-386. [PMID: 37930632 DOI: 10.1089/pop.2023.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
The relative distribution of proportions of cardiovascular health (CVH) categories within racial groups has been examined. However, little scientific evidence exists on the gap trend in racial/ethnic disparities in mean CVH score among non-Hispanic (NH) Whites and Blacks. This study examined the trend(s) in the gap(s) in predicted CVH scores between NH Whites and Blacks over 10 years. In a cross-sectional analytical study, 10 years of Medical Expenditure Panel Survey data from 2008 to 2018 were pooled, utilizing multivariate Poisson's regression of CVH metrics on race, while controlling for relevant covariates. The interactions of acute coronary syndrome (ACS) with CVH metrics, and other key variables such as trends and grouped Charlson Comorbidity Index allowed for variations in the effect of these variables on the subgroups. The mean gap in CVH scores was on average 0.15 [95% confidence interval (CI) 0.137 to 0.170], with Blacks consistently having reduced odds of having ideal CVH until 2014. The overall impact of having an ACS decreased acquired CVH scores by 24.1% [95% CI -0.275 to 0.207], and was equal for both racial subgroups (P < 0.05). The Affordable Care Act (ACA)-trend was positive, increasing the likelihood of improved CVH in the sample (P < 0.05), deflecting a downward trend in acquired CVH scores for both races, as the gap narrowed into more recent years. The CVH gap was stabilized by the ACA, but never really converged, suggesting that efforts to reduce existing disparities between Blacks and NH Whites in the United States would require government policies to look beyond mere "access" and/or "affordability" to health care.
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Affiliation(s)
- Abraham Enyeji
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
| | - Noël C Barengo
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
- Department of Medical and Population Health Sciences, Education, and Research, Translational Medicine, Florida International University, Miami, Florida, USA
- Department of Medicine, Riga Stradins University, Riga, Latvia
| | - Gilbert Ramirez
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
| | - Alejandro Arrieta
- Department of Global Health, and Robert Stempel College of Public Health and Social Works, Florida International University, Miami, Florida, USA
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Rios-Escalante C, Albán-Fernández S, Espinoza-Rojas R, Saavedra-Garcia L, Barengo NC, Guerra Valencia J. Diagnostic Performance of the Measurement of Skinfold Thickness for Abdominal and Overall Obesity in the Peruvian Population: A 5-Year Cohort Analysis. Int J Environ Res Public Health 2023; 20:7089. [PMID: 38063518 PMCID: PMC10706145 DOI: 10.3390/ijerph20237089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 12/18/2023]
Abstract
The escalating prevalence of overall and abdominal obesity, particularly affecting Latin America, underscores the urgent need for accessible and cost-effective predictive methods to address the growing disease burden. This study assessed skinfold thicknesses' predictive capacity for overall and abdominal obesity in Peruvian adults aged 30 or older over 5 years. Data from the PERU MIGRANT 5-year cohort study were analyzed, defining obesity using BMI and waist circumference. Receiver operating characteristic curves and area under the curve (AUC) with 95% confidence intervals (CI) were calculated. Adults aged ≥ 30 (n = 988) completed the study at baseline, with 47% male. A total of 682 participants were included for overall and abdominal obesity analysis. The 5-year prevalence values for overall and abdominal obesity were 26.7% and 26.6%, respectively. Subscapular skinfold (SS) best predicted overall obesity in men (AUC = 0.81, 95% CI: 0.75-0.88) and women (AUC = 0.77, 95% CI: 0.67-0.88). Regarding abdominal obesity, SS exhibited the highest AUC in men (AUC = 0.83, 95% CI: 0.77-0.89), while SS and the sum of trunk skinfolds showed the highest AUC in women. In secondary analysis excluding participants with type-2 diabetes mellitus (DM2) at baseline, SS significantly predicted DM2 development in men (AUC = 0.70, 95% CI: 0.58-0.83) and bicipital skinfold (BS) did in women (AUC = 0.73, 95% CI: 0.62-0.84). The findings highlight SS significance as an indicator of overall and abdominal obesity in both sexes among Peruvian adults. Additionally, SS, and BS offer robust predictive indicators for DM2.
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Affiliation(s)
- Cristian Rios-Escalante
- Escuela de Nutrición y Dietética, Universidad Científica del Sur, Lima 15067, Peru; (C.R.-E.); (S.A.-F.)
| | - Silvia Albán-Fernández
- Escuela de Nutrición y Dietética, Universidad Científica del Sur, Lima 15067, Peru; (C.R.-E.); (S.A.-F.)
| | - Rubén Espinoza-Rojas
- Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima 15039, Peru;
| | - Lorena Saavedra-Garcia
- Carrera de Nutrición y Dietética, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru;
| | - Noël C. Barengo
- Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA;
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata 7600, Argentina
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Khan S, Sheikh T, Castro G, Barengo NC. Effect Modification of Race on the Associated Tumor Size at Diagnosis and 10-Year Cancer Survival Rates in Women with Cervical Squamous Cell Carcinoma in the United States. Int J Environ Res Public Health 2023; 20:6742. [PMID: 37754602 PMCID: PMC10530672 DOI: 10.3390/ijerph20186742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND While there may be an association between race, tumor size, and survival in patients with cervical squamous cell carcinoma (SCC), evidence on the effect of race on the association between tumor size at diagnosis and survival is limited. Our study evaluated whether race modifies the association between tumor size and 10-year survival in cervical SCC. METHODS This non-concurrent cohort study with the Surveillance, Epidemiology, and End Results (SEER) database included women diagnosed with cervical SCC between 2004-2018. The independent variable was diagnosis tumor size, where 2-4 cm was classified as high risk, and <2 cm was considered low risk. The dependent variable was 10-year cancer-specific survival rates, and race was our effect modifier. Unadjusted and adjusted Cox regression analysis were conducted to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS While a higher proportion of Black/Asian/Pacific Islander patients presented with tumor sizes of 2-4 cm compared to <2 cm (32.8% vs. 22.3%; p = 0.007) and having a tumor size of 2-4 cm had a significantly decreased 10-year survival (HR: 2.7; 95% CI: 1.3-5.8), the interaction between race and 10-year cancer-specific survival was not significant. CONCLUSION Although race did not modify the interaction between tumor size and 10-year survival, emphasis needs to be placed on screening and proper data collection, especially for minority races, and studies with larger sample sizes should be conducted in order to better implement future recommendations to improve health and survival.
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Affiliation(s)
- Samara Khan
- Division of Medical and Population Health Sciences Education and Research, Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (T.S.); (G.C.); (N.C.B.)
| | - Tooba Sheikh
- Division of Medical and Population Health Sciences Education and Research, Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (T.S.); (G.C.); (N.C.B.)
| | - Grettel Castro
- Division of Medical and Population Health Sciences Education and Research, Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (T.S.); (G.C.); (N.C.B.)
| | - Noël C. Barengo
- Division of Medical and Population Health Sciences Education and Research, Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (T.S.); (G.C.); (N.C.B.)
- Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata 7600, Argentina
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Nieto-Martinez R, Barengo NC, Restrepo M, Grinspan A, Assefi A, Mechanick JI. Large scale application of the Finnish diabetes risk score in Latin American and Caribbean populations: a descriptive study. Front Endocrinol (Lausanne) 2023; 14:1188784. [PMID: 37435487 PMCID: PMC10332265 DOI: 10.3389/fendo.2023.1188784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/02/2023] [Indexed: 07/13/2023] Open
Abstract
Background The prevalence of type 2 diabetes (T2D) continues to increase in the Americas. Identifying people at risk for T2D is critical to the prevention of T2D complications, especially cardiovascular disease. This study gauges the ability to implement large population-based organized screening campaigns in 19 Latin American and Caribbean countries to detect people at risk for T2D using the Finnish Diabetes Risk Score (FINDRISC). Methods This cross-sectional descriptive analysis uses data collected in a sample of men and women 18 years of age or older who completed FINDRISC via eHealth during a Guinness World Record attempt campaign between October 25 and November 1, 2021. FINDRISC is a non-invasive screening tool based on age, body mass index, waist circumference, physical activity, daily intake of fruits and vegetables, history of hyperglycemia, history of antihypertensive drug treatment, and family history of T2D, assigning a score ranging from 0 to 26 points. A cut-off point of ≥ 12 points was considered as high risk for T2D. Results The final sample size consisted of 29,662 women (63%) and 17,605 men (27%). In total, 35% of subjects were at risk of T2D. The highest frequency rates (FINDRISC ≥ 12) were observed in Chile (39%), Central America (36.4%), and Peru (36.1%). Chile also had the highest proportion of people having a FINDRISC ≥15 points (25%), whereas the lowest was observed in Colombia (11.3%). Conclusions FINDRISC can be easily implemented via eHealth technology over social networks in Latin American and Caribbean populations to detect people with high risk for T2D. Primary healthcare strategies are needed to perform T2D organized screening to deliver early, accessible, culturally sensitive, and sustainable interventions to prevent sequelae of T2D, and reduce the clinical and economic burden of cardiometabolic-based chronic disease.
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Affiliation(s)
- Ramfis Nieto-Martinez
- Departments of Global Health and Population and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
- Precision Care Clinic Corp., Saint Cloud, FL, United States
- Foundation for Clinic, Public Health, Epidemiology Research of Venezuela (FISPEVEN INC), Caracas, Venezuela
| | - Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine & Department of Global Health, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
- Faculty of Medicine, Riga Stradiņš University, Riga, Latvia
| | - Manuela Restrepo
- Medical Affairs Latin America, Merck Kommanditgesellschaft auf Aktien (KGaA), Darmstadt, Germany
| | - Augusto Grinspan
- Medical Affairs Latin America, Merck Kommanditgesellschaft auf Aktien (KGaA), Darmstadt, Germany
| | - Aria Assefi
- Medical Affairs Latin America, Merck Kommanditgesellschaft auf Aktien (KGaA), Darmstadt, Germany
| | - Jeffrey I. Mechanick
- The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Enyeji AM, Barengo NC, Ibrahimou B, Ramirez G, Arrieta A. Association between Non-Dietary Cardiovascular Health and Expenditures Related to Acute Coronary Syndrome in the US between 2008-2018. Int J Environ Res Public Health 2023; 20:ijerph20095743. [PMID: 37174260 PMCID: PMC10178628 DOI: 10.3390/ijerph20095743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/17/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
Background: Acute Coronary Syndrome (ACS) causes the most deaths in the United States and accounts for the highest amount of healthcare spending. Cardiovascular Health (CVH) metrics have been widely used in primary prevention, but their benefits in secondary prevention on total healthcare expenditures related to ACS are largely unknown. This study aims to quantify the potential significance of ideal CVH scores as a tool in secondary cardiovascular disease prevention. Methods: In a cross-sectional analytical study, ten years of Medical Expenditure Panel Survey (MEPS) data from 2008 to 2018 were pooled, comparing ACS to non-ACS subgroups, utilizing a Two-part model with log link and gamma distribution, since our sample had both positive and zero costs. Conditional on positive expenditure, healthcare expenditure amounts were measured as a function of ACS status, socio-demographics, and CVH while controlling for relevant covariates. Finally, interactions of ACS with CVH metrics and other key variables were included to allow for variations in the effect of these variables on the two subgroups. Results: Improvements in CVH scores tended to reduce annual expenditures to a greater degree percentage-wise among ACS subjects compared to non-ACS groups, even though subjects with an ACS diagnosis tended to have approximately twice as big expenditures as similar subjects without an ACS diagnosis. Meanwhile, the financial impact of an ACS event on total expenditure would be approximately $88,500 ([95% CI, $70,200-106,900; p < 0.001]), and a unit improvement in CVH management score would generate savings of approximately $4160 ([95% CI, $5390-2950; p < 0.001]) in total health expenditures. Conclusions: Effective secondary preventive measures through targeted behavioral endeavors and improved health factors, especially the normalization of hypertension, diabetes mellitus, body mass index, and smoking cessation, have the potential to reduce medical spending for ACS subgroups.
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Affiliation(s)
- Abraham M Enyeji
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, FL 33174, USA
| | - Noël C Barengo
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, FL 33174, USA
- Division of Medical and Population Health Sciences Education and Research, Translational Medicine, Florida International University, Miami, FL 33199, USA
- Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia
| | - Boubakari Ibrahimou
- Department of Biostatistics Robert Stempel, College of Public Health & Social Works, Florida International University, Miami, FL 33199, USA
| | - Gilbert Ramirez
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, FL 33174, USA
| | - Alejandro Arrieta
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Works, Florida International University, Miami, FL 33174, USA
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Taborda Restrepo PA, Acosta-Reyes J, Estupiñan-Bohorquez A, Barrios-Mercado MA, Correa Gonzalez NF, Taborda Restrepo A, Barengo NC, Gabriel R. Comparative Analysis of Clinical Practice Guidelines for the Pharmacological Treatment of Type 2 Diabetes Mellitus in Latin America. Curr Diab Rep 2023; 23:89-101. [PMID: 37126189 PMCID: PMC10160131 DOI: 10.1007/s11892-023-01504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE OF REVIEW Type 2 diabetes mellitus (T2DM) is one of the leading causes of death and disability in the world. The majority of diabetes deaths (> 80%) occur in low- and middle-income countries, which are predominant in Latin America. Therefore, the purpose of this article is to compare the clinical practice guideline (CPG) for the pharmacological management of T2DM in Latin America (LA) with international reference guidelines. RECENT FINDINGS Several LA countries have recently developed CPGs. However, the quality of these guidelines is unknown according to the AGREE II tool and taking as reference three CPGs of international impact: American Diabetes Association (ADA), European Diabetes Association (EASD), and Latin American Diabetes Association (ALAD). Ten CPGs were selected for analysis. The ADA scored > 80% on the AGREE II domains and was selected as the main comparator. Eighty percent of LA CPGs were developed before 2018. Only one was not recommended (all domains < 60%). The CPGs in LA have good quality but are outdated. They have significant gaps compared to the reference. There is a need for improvement, as proposing updates every three years to maintain the best available clinical evidence in all guidelines.
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Affiliation(s)
| | - Jorge Acosta-Reyes
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | | | | | | | | | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine and Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Faculty of Medicine, Riga Stradins University, Riga, Latvia
| | - Rafael Gabriel
- International Health Department, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain, World Community for Prevention of Diabetes, Madrid, Spain
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Anillo Arrieta LA, Flórez Lozano KC, Tuesca Molina R, Acosta Vergara T, Rodríguez Acosta S, Aschner P, Diaz Montes Y, Nieto Castillo JP, Florez-Garcia VA, Barengo NC. Glycemic status and health-related quality of life (HRQOL) in populations at risk of diabetes in two Latin American cities. Qual Life Res 2023:10.1007/s11136-023-03398-x. [PMID: 37010804 PMCID: PMC10328894 DOI: 10.1007/s11136-023-03398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE To estimate the health-related quality of life (HRQOL) according to glycemic status, and its relationship with sociodemographic and clinical factors in a population at risk of developing type 2 diabetes (T2D). METHODS Cross-sectional study, using cluster sampling. Data were collected from 1135 participants over 30 years of age, at risk of developing T2D from the PREDICOL project. Participants' glycemic status was defined using an oral glucose tolerance test (OGTT). Participants were divided into normoglycemic subjects (NGT), prediabetes and diabetics do not know they have diabetes (UT2D). HRQOL was assessed using the EQ-5D-3L questionnaire of the EuroQol group. Logistic regression and Tobit models were used to examine factors associated with EQ-5D scores for each glycemic group. RESULTS The mean age of participants was 55.6 ± 12.1 years, 76.4% were female, and one in four participants had prediabetes or unknown diabetes. Participants reported problems most frequently on the dimensions of Pain/Discomfort and Anxiety/Depression in the different glycemic groups. The mean EQ-5D score in NGT was 0.80 (95% CI 0.79-0.81), in prediabetes, 0.81 (95% CI 0.79-0.83), and in participants with UT2D of 0.79 (95% CI 0.76-0.82), respectively. Female sex, older age, city of residence, lower education, receiving treatment for hypertension, and marital status were significantly associated with lower levels of HRQOL in the Tobit regression analysis. CONCLUSIONS HRQOL of NGT, prediabetes, and UT2D participants was statistically similar. However, factors such as gender, age. and place of residence were found to be significant predictors of HRQOL for each glycemic group.
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Affiliation(s)
- Luis A Anillo Arrieta
- Division of Basic Sciences, Department of Mathematics and Statistics, Universidad del Norte, Barranquilla, Colombia.
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia.
| | - Karen C Flórez Lozano
- Division of Basic Sciences, Department of Mathematics and Statistics, Universidad del Norte, Barranquilla, Colombia
| | - Rafael Tuesca Molina
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
- ScienceFlows Research Group, University of Valencia, Valencia, Spain
| | - Tania Acosta Vergara
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Sandra Rodríguez Acosta
- Division of Humanities and Sciences, Division Social, Department of Economics, Universidad del Norte, Barranquilla, Colombia
| | - Pablo Aschner
- Asociación Colombiana de Diabetes, Bogotá, Colombia
- Javeriana University, Bogotá, Colombia
- San Ignacio University Hospital, Bogotá, Colombia
| | - Yenifer Diaz Montes
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Julieth P Nieto Castillo
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Víctor Alfonso Florez-Garcia
- Division of Health Sciences, Department of Public Health, Universidad del Norte, Barranquilla, Colombia
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Global Health, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee, USA
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Raslan S, Rodriguez E, Zheng C, Lozanoa J, Barengo NC, Sargi Z. Association Between Mortality Due to Nasopharyngeal Carcinoma and Race in the United States From 2007 to 2016. Asian Pac J Cancer Prev 2023; 24:915-921. [PMID: 36974545 DOI: 10.31557/apjcp.2023.24.3.915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Asians and Pacific Islanders (API) exhibit increased incidence of nasopharyngeal carcinoma (NPC). However, they are often excluded when the disease is studied. Risk-factors and incidence are well-researched while cancer-specific mortality trends remain unclear. We aimed to determine whether insurance status modifies the association between race and cancer-specific mortality in NPC patients. METHODS This retrospective cohort study used secondary data analysis from the Surveillance, Epidemiology, and End Results Program database. Patients ≥18 years with histologically confirmed primary NPC from 2007 - 2016 were included. The main outcome assessed was 5-year survival and the main exposure variable was race (API, white, black). Insurance status was classified into uninsured, any Medicaid, and insured (with any insurance). Potential confounders included age, sex, marital status, stage at diagnosis, and surgical treatment. Adjusted Cox regression analysis was used to calculate hazard ratios (HR) and corresponding 95% confidence intervals (CI). RESULTS 1610 patients were included (72.98% male, 27.02% female). 49.8% were API, 40.5% were Whites, and 9.8% Blacks. Maximum follow-up was 5-years. The adjusted hazards of 5-year cancer-specific death for API and Blacks compared with Whites were 0.77 (95% CI 0.62 - 0.96) and 0.92 (95% CI 0.65 - 1.31), respectively. Cases decreased with age in API and Blacks. 8.2% of cases had localized disease, 45.3% had local spread, and 44.6% had distant metastasis. Insurance status did not modify the association between race and mortality. CONCLUSION Race is an important prognostic factor to account for in NPC patients. Investigating risk-factors and subtypes stratified by race may explain our findings.
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Affiliation(s)
- Shahm Raslan
- Department of Translational Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
| | - Edwin Rodriguez
- Department of Translational Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
| | - Chengcheng Zheng
- Department of Translational Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
| | - Juan Lozanoa
- Department of Translational Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
| | - Noël C Barengo
- Department of Translational Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
- Faculty of Medicine, Riga Stradins University, Riga, Latvia, United States
- Department of Public Health, Faculty of Medicine, Riga Stradins University, Riga, Latvia, United States
| | - Zoukaa Sargi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, United States
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13
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Varella MH, Andrade OA, Shaffer SM, Castro G, Rodriguez P, Barengo NC, Acuna JM. E-cigarette use and respiratory symptoms in residents of the United States: A BRFSS report. PLoS One 2022; 17:e0269760. [PMID: 36454742 PMCID: PMC9714717 DOI: 10.1371/journal.pone.0269760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022] Open
Abstract
PURPOSE E-cigarettes are the most common type of electronic nicotine delivery system in the United States. E-cigarettes contain numerous toxic compounds that has been shown to induce severe structural damage to the airways. The objective of this study is to assess if there is an association between e-cigarette use and respiratory symptoms in adults in the US as reported in the BRFSS. METHODS We analyzed data from 18,079 adults, 18-44 years, who participated at the Behavioral Risk Factor Surveillance System (BRFSS) in the year 2017. E-cigarette smoking status was categorized as current everyday user, current some days user, former smoker, and never smoker. The frequency of any respiratory symptoms (cough, phlegm, or shortness of breath) was compared. Unadjusted and adjusted logistic regression analysis were used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS The BRFSS reported prevalence of smoking e-cigarettes was 6%. About 28% of the participants reported any of the respiratory symptoms assessed. The frequency of reported respiratory symptoms was highest among current some days e-cigarette users (45%). After adjusting for selected participant's demographic, socio-economic, and behavioral characteristics, and asthma and COPD status, the odds of reporting respiratory symptoms increased by 49% among those who use e-cigarettes some days (OR 1.49; 95% CI: 1.06-2.11), and by 29% among those who were former users (OR 1.29; 95% CI: 1.07-1.55) compared with those who never used e-cigarettes. No statistically significant association was found for those who used e-cigarettes every day (OR 1.41; 95% CI 0.96-2.08). CONCLUSION E-cigarettes cannot be considered as a safe alternative to aid quitting use of combustible traditional cigarettes. Cohort studies may shed more evidence on the association between e-cigarette use and respiratory diseases.
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Affiliation(s)
- Marcia H. Varella
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States of America
| | - Olyn A. Andrade
- American University of Antigua College of Medicine, United States of America
| | - Sydney M. Shaffer
- American University of Antigua College of Medicine, United States of America
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States of America
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States of America
| | - Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States of America
- Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States of America
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Juan M. Acuna
- Department of Epidemiology and Aw 8474000331 R-DISC, Khalifa University, Abu Dhabi, United Arab Emirates
- CRUSADA, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States of America
- * E-mail:
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14
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Oweisi A, Mustafa MS, Mustafa LS, Eily AN, Rodriguez de la Vega P, Castro G, Barengo NC. The Association between Race/Ethnicity and Cancer Stage at Diagnosis of Bone Malignancies: A Retrospective Cohort Study. Int J Environ Res Public Health 2022; 19:15802. [PMID: 36497878 PMCID: PMC9739147 DOI: 10.3390/ijerph192315802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION AND OBJECTIVE Limited data exists analyzing disparities in diagnosis regarding primary bone neoplasms (PBN). The objective of our study was to determine if there is an association between race/ethnicity and advanced stage of diagnosis of PBN. METHODS This population-based retrospective cohort study included patient demographic and health information extracted from the National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER). The main exposure variable was race/ethnicity categorized as non-Hispanic white (NH-W), non-Hispanic black (NH-B), non-Hispanic Asian Pacific Islander (NH-API), and Hispanic. The main outcome variable was advanced stage at diagnosis. Age, sex, tumor grade, type of bone cancer, decade, and geographic location were co-variates. Unadjusted and adjusted logistic regression analyses were conducted calculating odds ratios (OR) and corresponding 95% confidence intervals. RESULTS Race/ethnicity was not statistically significantly associated with advanced-stage disease. Adjusted OR for NH-B was 0.94 (95% CI: 0.78-1.38), for NH-API 1.07 (95% CI: 0.86-1.33) and for Hispanic 1.03 (95% CI: 0.85-1.25). CONCLUSIONS The lack of association between race and advanced stage of disease could be due to high availability and low cost for initial management of bone malignancies though plain radiographs. Future studies may include socioeconomic status and insurance coverage as covariates in the analysis.
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Affiliation(s)
- Ayman Oweisi
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Moawiah S. Mustafa
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Luai S. Mustafa
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Alyssa N. Eily
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Pura Rodriguez de la Vega
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
- Department of Global Health, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA
- Faculty of Medicine, Riga Stradiņš University, LV-1007 Riga, Latvia
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15
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Bedoya JPP, Cardozo OIM, Aguirre CAP, Galvis LMR, Escudero JPS, Jimenez JC, Rey BAR, Barengo NC, Valencia PAD. Association between the Multidimensional Poverty Measure and COVID-19 mortality in Colombia. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Different socioeconomic aspects have been related to mortality from COVID-19. For this reason, the objective of this study was to analyze the association between the Multidimensional Poverty Measure at the municipal level (MPM) and the clinical outcome of mortality in the resident population of Colombia with a diagnosis of COVID-19.
Methods
Observational, non-concurrent cohort study of confirmed cases of COVID-19 reported in Colombia by August 2021. The main outcome variable was mortality from COVID-19, and the main exposure variable was MPM. The covariates included in the analysis were patient's sex, age, and municipality of residence. Unadjusted and adjusted logistic models were used using balanced random samples of deaths and recovered patients, calculating odds ratios (OR) and 95% confidence interval ranges (CI).
Results
In total, 4,194,538 cases of COVID-19 were included in the analysis, of which approximately 3% died. According to the adjusted multivariate analysis, it was found that patients who live in municipalities with an MPM between 20 to 40%, 41 to 60%, 61 to 80% and more than 80% had an OR of 1.6 (95% CI 1.4 to 1.8), 1.6 (95% CI 1.3 to 1.9), 1.7 (95% CI 1.2 to 2.5), and 2.2 (95% CI 0.7 to 7.8), respectively, for mortality from COVID-19 compared with an MPM of less than 20%. When analyzing the data according to sex for the MPM from 20 to 40%, 41 to 60%, 61 to 80% and more than 80%, an OR for women of 1.7 (95% CI 1.5 to 2.0), 1.8 (95% CI % 1.5 to 2.1), 1.9 (95% CI 1.3 to 2.6) and 2.8 (CI 0.9 to 10.1) respectively. For men an OR of 1.5 (95% CI 1.3 to 1.7), 1.4 (95% CI 1.2 to 1.7), 1.6 (95% CI 1.1 to 2.3) and 1.9 (95% CI 0.6 to 6.0) respectively compared to a MPM less than 20%.
Conclusions
The risk of mortality from COVID-19 in Colombia is increased in populations with higher MPM. Social determinants of health have an important effect on the outcomes of COVID-19.
Key messages
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Affiliation(s)
- JP Perez Bedoya
- National School of Public Health, University of Antiquia , Medellín, Colombia
| | - OI Mendoza Cardozo
- National School of Public Health, University of Antiquia , Medellín, Colombia
| | - CA Pérez Aguirre
- Statistics Institute, National University of Colombia , Medellín, Colombia
| | - LM Ruiz Galvis
- National School of Public Health, University of Antiquia , Medellín, Colombia
| | - JP Sánchez Escudero
- National School of Public Health, University of Antiquia , Medellín, Colombia
| | - J Cardona Jimenez
- Statistics Institute, National University of Colombia , Medellín, Colombia
| | | | - NC Barengo
- Herbert Wertheim College, Florida International University , Miami, Colombia
| | - PA Diaz Valencia
- National School of Public Health, University of Antiquia , Medellín, Colombia
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16
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Smith D, Santiago J, Castro G, de la Vega PR, Barengo NC. Adequacy of Healthcare by Insurance Type in Traumatic Brain Injury Patients. Journal of Health Management 2022. [DOI: 10.1177/09720634221128095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Traumatic brain injury (TBI) is a significant contributor to disability, especially among patients younger than 18 years old in the United States. While insurance is often needed to receive services, studies investigating whether TBI treatment adequacy is dependent on the insurance type are scant. Our objective was to determine whether private insurance in paediatric TBI patients is associated with a higher perceived adequacy of healthcare compared with non-private insurance. This was a cross-sectional study utilising secondary data collected from the National Survey of Children Health 2011/12. The main exposure of interest was the insurance status of children at the time of a TBI (private vs non-private). The study outcome was the perceived adequacy of healthcare, defined as having coverage needs that were usually or always met by insurance. Unadjusted and adjusted logistic regression analysis were used. After adjustments for the covariates, the odds of adequate healthcare among those with non-private insurance compared with those with private were not statistically significant (OR 1.49; 95% CI 0.87–2.55). This study implicates paediatric TBI patients do not believe they receive adequate healthcare independent of insurance status. Clinicians, policy makers, and researchers need to better evaluate and address this issue.
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Affiliation(s)
- Drew Smith
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA
| | - Juan Santiago
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA
| | - Grettel Castro
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA
| | | | - Noël C. Barengo
- Florida International University, Herbert Wertheim College of Medicine, Miami, Florida, USA
- Faculty of Medicine, Rīga Stradiņš University, Riga, Latvia
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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17
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Smith DH, Grewal J, Mehboob S, Mohan S, Pombo LF, Rodriguez P, Gonzalez JC, Zevallos J, Barengo NC. Association between ethnicity and hypertension in Northern Colombia in 2015. Clin Hypertens 2022; 28:18. [PMID: 35701852 PMCID: PMC9199244 DOI: 10.1186/s40885-022-00203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background Studies in the United States have shown a genetic predisposition to hypertension in individuals of African descent. However, studies on the associations between ethnic groups and hypertension in Latin America are lacking and the limited results have been inconsistent. The objective of this study is to determine whether Afro-Colombian ethnicity increases the risk of hypertension. Methods This study is a secondary data analysis of a cross sectional study from five provinces in Northern Colombia. Randomly selected individuals (N = 2613; age-range 18–74 years) enrolled in a health care insurance company underwent physical examinations and completed questionnaires regarding ethnicity, lifestyle, and other risk factors. Hypertension in these patients was determined. Unadjusted and adjusted logistic regression analysis were calculated to determine the association between ethnicity and hypertension. Results No association between Afro-Colombian ethnicity and hypertension was found (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.66–1.09). As expected, people with a body mass index (BMI) of 30 or higher were at a greater risk of having hypertension (OR, 3.12; 95% CI, 2.35–4.16) compared with those with a normal BMI. Conclusions Findings from this study suggest no independent association between Afro-Colombian ethnicity and hypertension. Further research should focus on genotyping or socioeconomic factors such as income level.
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Affiliation(s)
- Drew H Smith
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA. .,Florida International University Herbert Wertheim College of Medicine, 11200 SW 8th Street, 33199, Miami, FL, USA.
| | - Jaskaran Grewal
- American University of Antigua, Osbourn, Antigua and Barbuda
| | - Saba Mehboob
- American University of Antigua, Osbourn, Antigua and Barbuda
| | - Shiva Mohan
- American University of Antigua, Osbourn, Antigua and Barbuda
| | - Luisa F Pombo
- Observatorio de Diabetes de Colombia, Organización para la Excelencia de la Salud, Bogotá, Colombia
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Juan Carlos Gonzalez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Juan Zevallos
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.,Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Miami, FL, USA.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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18
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Lapica H, Ozery M, Raju H, Castro G, Rodriguez de la Vega P, Barengo NC. The Associations between Racial Disparities, Health Insurance, and the Use of Amputation as Treatment for Malignant Primary Bone Neoplasms in the US: A Retrospective Analysis from 1998 to 2016. Int J Environ Res Public Health 2022; 19:6289. [PMID: 35627824 PMCID: PMC9140582 DOI: 10.3390/ijerph19106289] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Primary bone neoplasms (PBNs) represent less than 1% of diagnosed cancers each year. Significant treatment disparities exist between racial and ethnic groups. We investigated patients with PBNs to determine an association between race/ethnicity and procedure-type selection. A non-concurrent cohort study was conducted using the SEER database. Patients diagnosed with PBNs between 1998 and 2016 were included (n = 5091). Patients were classified into three racial groups (Black, White and Asian Pacific Islanders) and were assessed by procedure-type received. The outcome was amputation. Race was not associated with increased amputation incidence. Hispanic patients had a 40% increased likelihood of amputation (OR 1.4; 95% CI 1.2-1.6). Insurance status was an independent predictor of procedure selection. Uninsured patients were 70% more likely to receive amputation than insured patients (OR 1.7; 95% CI 1.1-2.8). We recommend provider awareness of patients less likely to seek regular healthcare in the context of PBNs.
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Affiliation(s)
- Hans Lapica
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Matan Ozery
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Harsha Raju
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Pura Rodriguez de la Vega
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
- Department of Health Policy & Management, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
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19
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Jamieson SC, Mallory CW, Jivanji DR, Perez A, Castro G, Barengo NC, Pereira J, Nieder AM. AUTHOR REPLY. Urology 2022; 163:118. [PMID: 35636843 DOI: 10.1016/j.urology.2021.05.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/02/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Scott C Jamieson
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Chase W Mallory
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Dhaval R Jivanji
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Alejandra Perez
- Columbia University Division of Urology, Mount Sinai Medical Center, FL
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Jorge Pereira
- Columbia University Division of Urology, Mount Sinai Medical Center, FL
| | - Alan M Nieder
- Columbia University Division of Urology, Mount Sinai Medical Center, FL
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Barengo NC, Apolinar LM, Estrada Cruz NA, Fernández Garate JE, Correa González RA, Diaz Valencia PA, Gonzalez CAC, Rodriguez JAG, González NC, Arellano Flores ML, Ledesma Muñoz ME, Gonzalez Sotelo DA, Davila Maldonado OM, Gomez Garcia JG, Laureano Hernandez FJ, Jimenez JEZ, Pulido Garcia BA, Vazquez HR, Ramirez Dorantes AA, Gonzalez Fierro LA, Hernandez Hernandez JC, Perez JZ. Development of an information system and mobile application for the care of type 2 diabetes patients at the primary care level for the health sector in Mexico: study protocol for a randomized controlled, open-label trial. Trials 2022; 23:253. [PMID: 35379298 PMCID: PMC8981629 DOI: 10.1186/s13063-022-06177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/16/2022] [Indexed: 12/05/2022] Open
Abstract
Background Providing optimal care for type 2 diabetes (DM2) patients remains a challenge for all healthcare systems. Patients often encounter various barriers in adhering to self-management programs due to lack of knowledge and understanding of self-care activities, lack of individualized and coordinated care, inconvenient and costly education sessions, and poor patient-provider communication. Mobile technologies such as cell phones/smartphones, handheld tablets, and other wireless devices offer new and exciting opportunities for addressing some of these challenges. The purpose of this study is to compare a diabetes management strategy using an information board and a mobile application versus standard care in patients with uncontrolled DM2. Method The SANENT (Sistema de Análisis de Enfermedades No Transmisibles) trial is a primary care-based, prospective, two-arm, randomized controlled, open-label, blinded-endpoint study. We aim to recruit 1440 DM2 patients during a period of 6 months until the requested number of participants has been achieved. The total length of the intervention will be 1 year. Both men and women treated for DM2 with an HbA1c > 8.5% and ≥ 20 years of age are eligible to participate in the study. The primary outcome of the study is improved diabetes control measured by changes in HbA1c in the study participants. HbA1c will be measured at baseline, 3-month, 6-month, 9-month, and 12-month follow-up visits in all participants. The main analysis will be based on the intention-to-treat principle. The primary endpoint of the study will be the change in HbA1C within the groups and the differences between the groups. This will be assessed by a repeated measurement approach based on mixed models which contain both fixed effects and random effects. Discussion The overall goal of this project is to contribute to the evidence for the use of mobile technology to improve the treatment and regulation of poorly controlled DM2 patients living in Mexico. Our proposed project will show how mobile health technology tools can be used in the treatment of patients with uncontrolled DM2 in primary health care in a Latin American population, and particularly how they could help diabetes patients take better care of themselves. Trial registration ClinicalTrials.gov, US National Institutes of Health NCT04974333. Prospectively registered on July 13, 2021. Protocol version number 1, dated August 15th, 2021.
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21
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Barengo NC, Alkhatib A. Editorial: Physical Activity, Health Equity and Health Related Outcomes. Front Public Health 2022; 10:828108. [PMID: 35284398 PMCID: PMC8907581 DOI: 10.3389/fpubh.2022.828108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
- *Correspondence: Noël C. Barengo
| | - Ahmad Alkhatib
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
- Ahmad Alkhatib
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22
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Barengo NC, Diaz Valencia PA, Apolina LM, Estrada Cruz NA, Fernández Garate JE, Correa González RA, Cinco Gonzalez CA, Gómez Rodriguez JA, González NC. Mobile Health Technology in the Primary Prevention of Type 2 Diabetes: a Systematic Review. Curr Diab Rep 2022; 22:1-10. [PMID: 35113334 DOI: 10.1007/s11892-021-01445-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The objective of this review was to summarize the current scientific evidence of mobile health technology in the primary prevention of type 2 diabetes in patients with prediabetes derived from randomized clinical trials. RECENT FINDINGS Few randomized clinical trials are available using mobile health technologies in the prevention of type 2 diabetes. There is heterogeneity in regard to the main study outcomes, duration of interventions, and study findings. Inconsistent findings have been reported whether mobile health technologies are effective in reducing HbA1C levels or the incidence of type 2 diabetes in patients with prediabetes. However, results are promising that mobile health interventions may decrease body weight. Future study may consistently measure changes in glycemic indicators as well as develop elements that better address behavior changes.
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Affiliation(s)
- Noël C Barengo
- Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
- Division of Medical and Population Health Sciences Education and Research, Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
| | - Paula A Diaz Valencia
- Facultad Nacional de Salud Pública, Grupo de Epidemiología, Universidad de Antioquia, Medellín, Colombia
| | - Leticia Manuel Apolina
- Unidad de Investigación Médica en Enfermedades Endocrinas, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - José E Fernández Garate
- Unidad de Investigación Médica en Enfermedades Endocrinas, Instituto Mexicano del Seguro Social, Ciudad de México, México
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23
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Ogurtsova K, Guariguata L, Barengo NC, Ruiz PLD, Sacre JW, Karuranga S, Sun H, Boyko EJ, Magliano DJ. IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021. Diabetes Res Clin Pract 2022; 183:109118. [PMID: 34883189 DOI: 10.1016/j.diabres.2021.109118] [Citation(s) in RCA: 202] [Impact Index Per Article: 101.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/11/2022]
Abstract
AIMS To provide up-to-date estimates of undiagnosed diabetes mellitus (UDM) prevalence - both globally, and by region/country, for the year 2021. METHODS Data sources reporting diabetes prevalence were identified through a systematic search in the peer-reviewed and grey literature. The prevalence of undiagnosed diabetes was estimated from the data from each country where data was available. For countries without in-country data, the prevalence of undiagnosed diabetes was approximated by extrapolating the average of the estimates from countries with data sources within the same International Diabetes Federation (IDF) region and World Bank income grouping. We then applied these stratified prevalence estimates of UDM from each country to the number of adults in each strata and summed the counts to generate the number of adults with UDM (aged 20-79 years) for 215 countries and territories. RESULTS In 2021, almost one in two adults (20-79 years old) with diabetes were unaware of their diabetes status (44.7%; 239.7 million). The highest proportions of undiagnosed diabetes (53.6%) were found in the Africa, Western Pacific (52.8%) and South-East Asia regions (51.3%), respectively. The lowest proportion of undiagnosed diabetes was observed in North America and the Caribbean (24.2%). CONCLUSIONS Diabetes surveillance needs to be strengthened to reduce the prevalence of UDM, particularly in low- and middle-income countries.
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Affiliation(s)
- Katherine Ogurtsova
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
| | - Leonor Guariguata
- Faculty of Medical Sciences, University of the West Indies, Bridgetown, Barbados.
| | - Noël C Barengo
- Herbert Wertheim College of Medicine & Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.
| | - Paz Lopez-Doriga Ruiz
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway; Norwegian Institute of Public Health, Oslo, Norway.
| | - Julian W Sacre
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
| | - Suvi Karuranga
- The International Diabetes Federation, Brussels, Belgium.
| | - Hong Sun
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA.
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA.
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
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Anillo Arrieta LA, Acosta Vergara T, Tuesca R, Rodríguez Acosta S, Flórez Lozano KC, Aschner P, Gabriel R, De La Rosa S, Nieto Castillo JP, Barengo NC. Health-related quality of life (HRQoL) in a population at risk of type 2 diabetes: a cross-sectional study in two Latin American cities. Health Qual Life Outcomes 2021; 19:269. [PMID: 34930297 PMCID: PMC8686566 DOI: 10.1186/s12955-021-01894-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to describe the health-related quality of life (HRQoL) characteristics in a population at risk of developing type 2 diabetes in Barranquilla and Bogotá, Colombia. Methods A cross-sectional study with 1135 participants older than 30 years-of-age recruited in Bogotá D.C., and Barranquilla by cluster sampling in 2018 to 2019. The Finnish Diabetes Risk Score (FINDRISC) was used to detect participants at risk of developing type 2 diabetes (T2D). HRQoL was assessed using the EQ-5D-3L questionnaire. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and their corresponding 95% confidence intervals CI). Results Moderate or extreme problems appeared more frequently in the dimensions of Pain/Discomfort (60.8%) and Anxiety/Depression (30.8%). The mean score of the EQ-VAS was 74.3 (± 17.3), significantly larger in the state of complete health (11111) compared with those with problems in more than one of the quality-of-life dimensions. Being female and living in Bogota D.C., were associated with greater odds of reporting problems in the Pain (OR 1.6; 95% CI 1.2–2.2) and Discomfort dimensions (OR 1.6; 95% CI 1.2–2.0) respectively and Anxiety/Depression (OR 1.9; 95% CI 1.3–2.7), (OR 9.1; 95% CI 6.6–12.4), respectively. Conclusions As living place and sex were associated with dimensions of Pain/Discomfort and Anxiety/Depression in the HRQoL in people at risk of T2D, greater attention should be paid to these determinants of HRQoL to design and reorient strategies with a territorial and gender perspective to achieve better health outcomes. Plain English summary Diabetes is one of the four non-communicable diseases with increasing prevalence in the world, which has made it a serious public health problem. In Colombia, in 2019 diabetes affected 8.4% of the Colombian adult population and more than one million Colombian adults of this age group have hidden or undetected diabetes. This disease is not only characterized by increased premature mortality, loss of productivity, and economic impact, but it also involves a deterioration in the quality of life of people with diabetes with their respective families. However, very Little is known about health-related quality of life (HRQoL) in a population at risk or with prediabetes. This study has evaluated the quality of life in patients at risk of diabetes and their behavior with some variables as sociodemographic, lifestyle, history, and established their difference in two territories of the Colombian Caribbean. The results of this study indicate that the HRQoL of people at risk of type 2 diabetes is affected by factors such as gender, city, dysglycemia, medication for hypertension and education level. Therefore, greater attention should be paid to these determinants of HRQL to design and implement strategies that reduce this risk of developing type 2 diabetes, prevent prediabetes and improve the quality of life in prediabetic or diabetic patients.
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Affiliation(s)
- Luis A Anillo Arrieta
- Department of Mathematics and Statistics, Division of Basic Sciences, Universidad del Norte, Barranquilla, Colombia. .,Department of Public Health, Division of Health Sciences, Universidad del Norte, Barranquilla, Colombia.
| | - Tania Acosta Vergara
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Barranquilla, Colombia
| | - Rafael Tuesca
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Barranquilla, Colombia.,Department of Interdisciplinary Research, University Center CIFE, Cuernavacas-Morelos, Mexico
| | - Sandra Rodríguez Acosta
- Department of Economics, Division of Humanities and Sciences Division Social, Universidad del Norte, Barranquilla, Colombia
| | - Karen C Flórez Lozano
- Department of Mathematics and Statistics, Division of Basic Sciences, Universidad del Norte, Barranquilla, Colombia
| | - Pablo Aschner
- Asociación Colombiana de Diabetes, Bogotá, Colombia.,Javeriana University, Bogotá, Colombia.,San Ignacio University Hospital, Bogotá, Colombia
| | - Rafael Gabriel
- Department of International Health, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain.,World Community for Prevention of Diabetes (WCPD) Foundation, Madrid, Spain
| | - Sandra De La Rosa
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Barranquilla, Colombia
| | - Julieth P Nieto Castillo
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Barranquilla, Colombia
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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25
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Andrade L, Geffin R, Maguire M, Rodriguez P, Castro G, Alkhatib A, Barengo NC. The Associations Between Access to Recreational Facilities and Adherence to the American Heart Association's Physical Activity Guidelines in US Adults. Front Public Health 2021; 9:660624. [PMID: 34900883 PMCID: PMC8654348 DOI: 10.3389/fpubh.2021.660624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
Physical activity decreases the risk of long-term health consequences including cardiac diseases. According to the American Health Association (AHA), adults should perform at least 75 min of vigorous physical activity (PA) or 150 min of moderate PA per week to impact long-term health. Results of previous studies are varied and have yet to integrate perceived access to facilities with AHA PA guidelines. We investigated whether access to free or low-cost recreational facilities was associated with meeting the AHA PA guidelines. Methodology: This cross-sectional study utilized data extracted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) database collected in 2017 (n = 1,750). The main exposure variable was access to free or low-cost recreational facilities. The main outcome variable was meeting the AHA guidelines of 150 min moderate PA or 75 min vigorous PA per week. Covariates included age, sex, level of education, overall health, BMI, ethnicity, hours of work per week, income, and time living at current address. Unadjusted and adjusted logistic regression analysis were used to calculate measures of odds ratio (OR) and corresponding 95% confidence interval (CI). Results: Of the 1,750 included participants, 61.7% (n = 1,079) reported to have access to recreational facilities. Of those with access to facilities, 69.9% met AHA PA guidelines while 30.4% did not. After adjusting for covariates, participants who reported access to recreational facilities were 42% more likely to meet AHA PA guidelines compared with participants who did not (adjusted OR 1.42; 95% CI 1.14-1.76). Secondary results suggest that healthier individuals were more likely to have met AHA PA guidelines. Conclusions: Having access to free or low-cost recreational facilities such as parks, walking trails, bike paths and courts was associated with meeting the AHA PA guidelines. Increasing prevalence and awareness of neighborhood recreational facilities could assist in access to these facilities and increase the ability of individuals to meet AHA PA guidelines. Future research should determine which types of recreational facilities impact physical activity strongest and discover methods of increasing their awareness.
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Affiliation(s)
- Larissa Andrade
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Ryan Geffin
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Mark Maguire
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | - Ahmad Alkhatib
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
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26
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Pedrozo ME, De Assis D, Cabello A, Cañete F, Prieto-Alvarado F, Barengo NC. Determinación de sodio urinario como marcador bioquímico para estimar la ingesta de sal en trabajadores del Ministerio de Salud Pública y Bienestar Social, Paraguay. Mem Inst Investig Cienc Salud 2021. [DOI: 10.18004/mem.iics/1812-9528/2021.019.03.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
En América Latina, 13% de todas las muertes y 5,1% de los años de vida ajustados por discapacidad se deben a la hipertensión. El exceso de sodio en la dieta puede incrementar aproximadamente un 30% el riesgo de hipertensión. El objetivo fue determinar la concentración de sodio en orina de 24 de horas para estimar la ingesta de sal en trabajadores del Ministerio de Salud Pública y Bienestar Social (MSPBS). Estudio transversal, en trabajadores de 25 a 64 años (n = 397) del MSPBS en Asunción-Paraguay en el 2014. La información sociodemográfica y económica, así como los factores de riesgo de enfermedades cardiovasculares, se evaluaron mediante un cuestionario validado y desarrollado por la OMS. Los niveles de sodio y potasio en orina de 24 horas se midieron usando un protocolo estandarizado. La mediana de la ingesta diaria de sal fue de 13,7 g. La mediana de la excreción de sodio en orina de 24 horas fue de 239 mEq, superando el valor de excreción de sodio recomendado en un 20%. Los hombres tuvieron una excreción de sodio en orina de 24 horas más alta que las mujeres tanto en el grupo de 25 a 44 años (251 mEq / 24 horas frente a 218 mEq/ 24 horas) como en el grupo de 45 a 64 años (266 mEq / 24 horas frente a 233 mEq / 24 horas) de los participantes del estudio. En conclusión, la ingesta de sal fue notablemente superior a la recomendada por la OMS (<5g/d).
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27
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Harrison AE, Kozarek JDB, Yeh J, MacDonald JH, Ruiz-Pelaez JG, Barengo NC, Turcotte JJ, King PJ. Postoperative outcomes of total knee arthroplasty across varying levels of multimodal pain management protocol adherence. J Orthop 2021; 28:26-33. [PMID: 34744378 DOI: 10.1016/j.jor.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/17/2021] [Accepted: 10/10/2021] [Indexed: 01/08/2023] Open
Abstract
We examined the effect of varying multimodal pain management (MMPM) combinations on oral morphine milligram equivalents (OMME) and length of stay (LOS) after total knee arthroplasty (TKA). Five groups were compared based on the combination of multimodal analgesics ranging from no MMPM to full MMPM with acetaminophen, gabapentinoids, and celecoxib. After risk adjustment, MMPM was associated with decreased odds of LOS ≥2 days and OMME ≥75th percentile. MMPM protocols are effective at reducing LOS and postoperative narcotic requirements post-TKA. Patients appear to derive similar benefit from receiving all three medications, as well as various combinations of these drugs.
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Affiliation(s)
- Anna E Harrison
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Jason D B Kozarek
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Justin Yeh
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | | | - Juan G Ruiz-Pelaez
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Noël C Barengo
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA.,Florida International University, Robert Stempel College of Public Health and Social Work, Department of Health Policy and Management, Miami, FL, USA
| | | | - Paul J King
- Luminis Health Anne Arundel Medical Center, Annapolis, MD, USA
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Rehrer WC, Rinaldi JR, Boyd BO, Toonkel RL, Barengo NC. Association Between Preoperative Blood Transfusion and Postoperative Pulmonary Embolism. J Am Coll Surg 2021. [DOI: 10.1016/j.jamcollsurg.2021.08.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bricknell RA, Ducaud C, Figueroa A, Schwarzman LS, Rodriguez P, Castro G, Zevallos JC, Barengo NC. An association between electronic nicotine delivery systems use and a history of stroke using the 2016 behavioral risk factor surveillance system. Medicine (Baltimore) 2021; 100:e27180. [PMID: 34516517 PMCID: PMC8428735 DOI: 10.1097/md.0000000000027180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/20/2021] [Indexed: 01/05/2023] Open
Abstract
Electronic nicotine delivery systems (ENDS) are growing in use and many of the health implications with these devices remain unknown. This study aims to assess, using a survey representative of the USA general population, if an association exists between a history of ENDS use and a history of stroke.This cross-sectional study was a secondary data analysis using the 2016 behavioral risk factor surveillance system survey. The main exposure variable of the study was a self-reported history of ENDS use. The main outcome was a self-reported history of stroke. Covariates included sex, race, traditional cigarette use, smokeless tobacco use, chronic kidney disease, diabetes, myocardial infarction, and coronary artery disease. Unadjusted and adjusted logistic regression analyses were done. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) were calculated.Of the 486,303 total behavioral risk factor surveillance system survey participants, 465,594 met the inclusion criteria for this study of ENDS use and stroke. This study shows that current ENDS use was positively associated with a history of stroke. AOR of some daily ENDS use with stroke was 1.28 (95% CI: 1.02-1.61) and AOR of current daily ENDS use with stroke was 1.62 (95% CI: 1.18-2.31). The majority (55.9%) of current daily ENDS users reported former traditional cigarette smoking. Female sex, non-white ethnicity, elderly age, chronic kidney disease, coronary artery disease, diabetes, and traditional cigarette use characteristics were all also associated with increased odds of reporting a stroke.This study found a statistically significant and positive association between ENDS use and a history of stroke. Further research is warranted to investigate the reproducibility and temporality of this association. Nevertheless, this study contributes to the growing body of knowledge about the potential cardiovascular concerns related to ENDS use and the need for large cohort studies.
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Affiliation(s)
| | | | | | | | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | | | - Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
- Faculty of Medicine, Riga Stradins University, Riga, Latvia
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Jamieson SC, Mallory CW, Jivanji DR, Perez A, Castro G, Barengo NC, Pereira J, Nieder AM. THE ROLE OF HEALTH LITERACY IN PROSTATE CANCER SCREENING. Urology 2021; 163:112-118. [PMID: 34375651 DOI: 10.1016/j.urology.2021.05.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/17/2021] [Accepted: 05/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine if there is an association between self-reported health literacy and rates of prostate cancer screening through PSA testing. METHODS This secondary data analysis utilized information from the 2016 Behavioral Risk Factor Surveillance System (BRFSS). The primary exposure was self-reported health literacy, and the primary outcome was whether patients underwent prior PSA testing. Males 55-69 years old from 13 states were included in the study and were excluded if they had any missing data. Participants were categorized into low, moderate, or high level of health literacy. Confounders were adjusted for using binary logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS A total of 12,149 participants were included. Five percent of participants reported low health literacy, 54% moderate health literacy, and 41% high health literacy. Compared with study participants who self-reported high levels of health literacy, the odds of undergoing PSA testing were 59% lower in those with low health literacy (OR 0.41; 95% CI 0.28-0.64) and 30% lower in those with moderate health literacy (OR 0.70; 95% CI 0.60-0.83). CONCLUSIONS Our research demonstrates a positive association between self-reported health literacy and the likelihood of PSA screening. While PSA screening can be controversial, health literacy may serve as a window into which patients are more likely to be proactive in their urologic care. Future studies examining how health literacy effects other urologic conditions is necessary.
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Affiliation(s)
- Scott C Jamieson
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
| | - Chase W Mallory
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Dhaval R Jivanji
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Alejandra Perez
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Jorge Pereira
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
| | - Alan M Nieder
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
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Gabriel R, Acosta T, Florez K, Anillo L, Navarro E, Boukichou N, Acosta-Reyes J, Barengo NC, Lindström J, Tuomilehto JO, Aschner P. Validation of the Finnish Type 2 Diabetes Risk Score (FINDRISC) with the OGTT in Health Care Practices in Europe. Diabetes Res Clin Pract 2021; 178:108976. [PMID: 34302911 DOI: 10.1016/j.diabres.2021.108976] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/28/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
AIMS /hypothesis. To determine the best cut-off threshold value of the Finnish Diabetes Risk Score (FINDRISC) for the detection of diabetes and non-diabetic hyperglycaemia in people 35 years or older at primary health care settings in Europe. METHODS Cross-sectional study in 11,444 adults from primary health care centres using community and opportunistic screening approaches. All participants completed the FINDRISC questionnaire and underwent a 2-hour oral glucose tolerance test (OGTT). The FINDRISC performance was assessed by the area under the curve (AUC) using receiver operating characteristics (ROC) analysis. The sensitivity, specificity, Youdeńs index, positive and negative prediction values for different FINDRISC cut-offs were calculated. RESULTS The optimal FINDRISC value for detecting both diabetes or glucose impairment in the community - screened sample was 14 point with the associated AUC 0.75,5 (95 %CI 0.73,7-0.77,3). The optimal score in the opportunistic screening sample was 16 with the associated AUC only 0.60,4 (95% CI 0.56, 4-0.64, 4). CONCLUSIONS/INTERPRETATION The FINDRISC is a non-invasive tool useful for detecting people with unknown diabetes and glucose impairment in people visiting primary health centres in Europe.
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Affiliation(s)
- Rafael Gabriel
- Department of International Health, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain; World Community for Prevention of Diabetes (WCPD) Foundation, Madrid, Spain.
| | - Tania Acosta
- Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Karen Florez
- Departamento de Matemáticas y Estadística, Universidad del Norte, Barranquilla, Colombia
| | - Luis Anillo
- Department of Public Health, Universidad del Norte, Barranquilla, Colombia; Departamento de Matemáticas y Estadística, Universidad del Norte, Barranquilla, Colombia
| | - Edgar Navarro
- Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Nisa Boukichou
- Asociación de Investigación en Prevención de Diabetes y enfermedades Cardiovasculares (PREDICOR). Madrid, Spain
| | - Jorge Acosta-Reyes
- Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine Florida International University, Miami, USA; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaana Lindström
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko O Tuomilehto
- Department of International Health, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain; World Community for Prevention of Diabetes (WCPD) Foundation, Madrid, Spain; Department of Public Health, University of Helsinki, Helsinki, Finland; Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Pablo Aschner
- World Community for Prevention of Diabetes (WCPD) Foundation, Madrid, Spain; Javeriana University, Bogota, Colombia; San Ignacio University, Bogota, Colombia
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Fernandez J, Gonzalez R, Oves JC, Rodriguez P, Castro G, Barengo NC. Illicit Substance Use Disparities Among Lesbian, Gay, and Bisexual High School Students in the U.S. in 2017. J Adolesc Health 2021; 68:1170-1175. [PMID: 33814276 DOI: 10.1016/j.jadohealth.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Studies have demonstrated a disparity in sexual minority adolescents and substance use, possibly due to factors contributing to minority stress. The objective of this study is to investigate the association between self-identifying as lesbian, gay, or bisexual and illicit substance use compared to those who identify as heterosexual among high school students in the U.S. METHODS A secondary data analysis of a cross-sectional study was performed using data from the Youth Risk Behavior Surveillance System in 2017. The study included adolescents attending public, Catholic, or private U.S. high schools. Participants with missing data on substance use and sexual orientation were excluded. The final sample size was 12,370. The main outcome variable was illicit substance use, which included marijuana and cocaine, among others. The main exposure variable was students who identified as heterosexual, gay or lesbian, bisexual, and unsure. Binary logistic regression analysis was used to calculate unadjusted and adjusted odds ratios and 95% confidence intervals (CIs). RESULTS Participants who identified as bisexual had 1.65-fold increased odds (95% CI 1.32-2.05) of ever using illicit substance(s) compared to heterosexuals. Those who identified as "not sure" of their sexual identity had 1.37-fold increased odds of ever using illicit substance(s) compared to heterosexuals (95% CI 1.03-1.83). CONCLUSIONS The results will provide health professionals with more information about illicit substance use among lesbian, gay, or bisexual identified adolescents. An increase in the understanding of health disparities associated with sexual identity may assist in the development of interventions.
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Affiliation(s)
- Jessica Fernandez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Roberto Gonzalez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Juan C Oves
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Nie J, Haberstroh M, Acosta T, Huang W, Wang Y, Barengo NC. Independent and joint associations between leisure time physical activity and strength activities with mortality outcomes in older adults ≥65 years-of-age: a prospective cohort study. J Gerontol A Biol Sci Med Sci 2021; 76:2122-2131. [PMID: 33858013 DOI: 10.1093/gerona/glab114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Indexed: 11/13/2022] Open
Abstract
Scientific evidence regarding the combined effect of both aerobic leisure time physical activity (LTPA) and muscle strengthening activities on all-cause, CVD or cancer mortality in older adults is scant. The aim of the study was to investigate the associations between recommended physical activity and mortality in older adults ≥65 years-of-age. This prospective cohort study used data from the National Health Interview Surveys from 1997-2013 linked with mortality files through December 31, 2015 (n=89,962). The main outcomes included all-cause, cardiovascular disease (CVD) and cancer mortality. The main exposure variables were aerobic leisure time physical activity and guideline-concordant strength training during leisure time. Cox regression models were used to calculate the hazard ratios (HR) and the corresponding 95% confidence intervals (CI). Muscle-strengthening activity at least twice per week were associated with lower hazards of all-cause mortality (HR 0.92; 95% CI 0.88-0.96), CVD mortality (HR 0.90; 95% CI 0.81-0.99) and cancer mortality (HR 0.87; 95% CI 0.79-0.96). Those who reached the recommended weekly amount of LTPA, had lower hazard of all-cause mortality by 35% (HR 0.66; 95% CI 0.63-0.67), the hazard of CVD 38% (HR 0.62; 95% CI 0.58-0.67), and cancer mortality by 22% (HR 0.78; 95% CI 0.73-0.84). The hazard of death among those who were physically active in both leisure time and engaged in muscle-strengthening activities were 0.57 (95% CI 0.54-0.60) for all-cause mortality, 0.53 (95% CI 0.47-0.61) for CVD mortality, and 0.66 (95% CI 0.58-0.75) for cancer mortality. Thus, engaging in muscle-strengthening activity ≥2 times/week may provide additional benefits among physically active older adults.
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Affiliation(s)
- Jing Nie
- Department of Sociology & Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Michelle Haberstroh
- Department of Human Service Department and Department of Public Health, University of Illinois Springfield, Illinois, USA
| | - Tania Acosta
- Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Wentao Huang
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.,Faculty of Medicine, Riga Stradins University, Riga, Latvia.,Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
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Gregorio A, Vice S, Witt A, Castro G, Rodriguez P, Barengo NC, Acuna J. The association between taking a course or class in self-managing diabetes with diabetic ocular complications including diabetic retinopathy: A cross-sectional study. Prim Care Diabetes 2021; 15:121-125. [PMID: 32620429 DOI: 10.1016/j.pcd.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/14/2020] [Accepted: 06/22/2020] [Indexed: 10/24/2022]
Abstract
AIMS Diabetes currently affects 30.3 million people in the United States. The objective of this study was to investigate the association between taking a course in self-managing diabetes and diabetic ocular complications including diabetic retinopathy diagnosis (OC-RD). METHODS The sample was from the 2017 CDC's BRFSS participants. We included adults who self-reported they had diabetes. The exposure included those who took a course in how to self-manage diabetes. The outcome was those told they had OC-RD by a doctor. Unadjusted and adjusted logistic regression analysis were used to calculate the odds ratios (OR) and 95% confidence intervals (CI). RESULTS The odds of OC-RD decreased by 30% for those who did not attend a course compared to those who did (OR 0.70; 95% CI 0.60-0.80). Patients who saw a doctor showed a 50% increase in the odds of OC-RD than those who did not (OR 1.50; 95% CI 1.20-1.90). Those earning above $15,000 had a 10% decreased likelihood of OC-RD every time income level increased. CONCLUSIONS Taking a class on self-managing diabetes was associated with an increased risk of OC-RD in the diabetic population. Future studies may analyze how education will affect diabetic complications.
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Affiliation(s)
- Alexis Gregorio
- American University of Antigua College of Medicine, Antigua, Antigua and Barbuda.
| | - Shannon Vice
- American University of Antigua College of Medicine, Antigua, Antigua and Barbuda
| | - Alexandra Witt
- American University of Antigua College of Medicine, Antigua, Antigua and Barbuda
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Juan Acuna
- Department of Epidemiology and Public Health, Khalifa University College of Medicine and Health Sciences, United Arab Emirates
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Jivanji D, Jamieson S, Mallory C, Castro G, Barengo NC, Nieder AM. AUTHOR REPLY. Urology 2021; 148:190-191. [PMID: 33549215 DOI: 10.1016/j.urology.2020.10.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/18/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Dhaval Jivanji
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Scott Jamieson
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Chase Mallory
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Alan M Nieder
- Columbia University Division of Urology, Mount Sinai Medical Center, FL
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Silverberg EL, Sterling TW, Williams TH, Castro G, Rodriguez de la Vega P, Barengo NC. The Association between Social Determinants of Health and Self-Reported Diabetic Retinopathy: An Exploratory Analysis. Int J Environ Res Public Health 2021; 18:ijerph18020792. [PMID: 33477729 PMCID: PMC7832397 DOI: 10.3390/ijerph18020792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/19/2020] [Accepted: 01/14/2021] [Indexed: 11/16/2022]
Abstract
One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14–3.90), out of work (OR 2.82; 95% CI: 1.62–4.92), unable to work (OR 2.14; 95% CI: 1.57–2.91), did not graduate high school (OR 1.91; 95% CI: 1.30–2.79), only graduated high school (OR 1.43; 95% CI 1.08–1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09–1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients.
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Affiliation(s)
- Emily L. Silverberg
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (E.L.S.); (T.W.S.); (T.H.W.); (G.C.); (P.R.d.l.V.)
| | - Trevor W. Sterling
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (E.L.S.); (T.W.S.); (T.H.W.); (G.C.); (P.R.d.l.V.)
| | - Tyler H. Williams
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (E.L.S.); (T.W.S.); (T.H.W.); (G.C.); (P.R.d.l.V.)
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (E.L.S.); (T.W.S.); (T.H.W.); (G.C.); (P.R.d.l.V.)
| | - Pura Rodriguez de la Vega
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (E.L.S.); (T.W.S.); (T.H.W.); (G.C.); (P.R.d.l.V.)
| | - Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA; (E.L.S.); (T.W.S.); (T.H.W.); (G.C.); (P.R.d.l.V.)
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Department of Epidemiology and Public Health, College of Medicine, Riga Stradins University, LV-1007 Riga, Latvia
- Correspondence: ; Tel.: +1-305-842-8793
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Acosta T, Tuesca R, Florez K, Barengo NC, Anillo L, Flórez-García V, Acosta J, Carvajal L, de la Rosa S, Pachón MJ, Aschner P. Factors Associated With Low Physical Activity in Two Latin American Populations at Risk of Developing Type 2 Diabetes: An Exploratory Analysis. Front Public Health 2021; 8:589484. [PMID: 33520912 PMCID: PMC7842278 DOI: 10.3389/fpubh.2020.589484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/15/2020] [Indexed: 11/06/2022] Open
Abstract
Low level of physical activity is a risk factor for chronic non-communicable diseases. Specifically, people at risk of Type 2 Diabetes (T2D) have shown to benefit from being physically active. The objective of this study was to explore what factors were associated with low physical activity in people at high risk of T2D living in Bogota and Barranquilla, Colombia. Methodology: Cross-sectional study using baseline data from a quasi-experimental clinical trial (PREDICOL Project). The study included 1,135 participants of Bogota and Barranquilla that presented a high risk of developing T2D according to the Finnish Diabetes Risk Score (>12 points) and who underwent an oral glucose tolerance test. The main outcome variable was the level of physical activity assessed by the International Physical Activity Questionnaire. Unadjusted and adjusted logistic regression analysis were used to calculate odds ratios (OR) and the corresponding 95% confidence intervals (CI). Results: In total, 72.5% of the study participants had low level of physical activity. Participants in the age group between 45 and 54 years showed 74% greater odds of having low physical activity compared with the youngest age group (OR 1.74, 95% CI 1.1 −2.8). People living in Barranquilla were eight times more likely to have low physical activity compared with those in Bogotá D.C. (OR 8.1, 95% CI 5.7 to 11.4). Conclusion: A large proportion of the population at risk of developing D2T in two large cities of Colombia have a sedentary lifestyle. Interventions should be designed and implemented in order to increase physical activity in these populations.
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Affiliation(s)
- Tania Acosta
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | - Rafael Tuesca
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | - Karen Florez
- Departamento de Matemáticas y Estadística, Universidad del Norte, Barranquilla, Colombia
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Riga Stradins University, Riga, Latvia
| | - Luis Anillo
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | - Victor Flórez-García
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia.,Joseph J. Zilber School of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, United States
| | - Jorge Acosta
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | | | - Sandra de la Rosa
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| | | | - Pablo Aschner
- Asociación Colombiana de Diabetes, Bogotá, Colombia.,Javeriana University, Bogotá, Colombia.,San Ignacio University Hospital, Bogotá, Colombia
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Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, Barengo NC, Beaton AZ, Benjamin EJ, Benziger CP, Bonny A, Brauer M, Brodmann M, Cahill TJ, Carapetis J, Catapano AL, Chugh SS, Cooper LT, Coresh J, Criqui M, DeCleene N, Eagle KA, Emmons-Bell S, Feigin VL, Fernández-Solà J, Fowkes G, Gakidou E, Grundy SM, He FJ, Howard G, Hu F, Inker L, Karthikeyan G, Kassebaum N, Koroshetz W, Lavie C, Lloyd-Jones D, Lu HS, Mirijello A, Temesgen AM, Mokdad A, Moran AE, Muntner P, Narula J, Neal B, Ntsekhe M, Moraes de Oliveira G, Otto C, Owolabi M, Pratt M, Rajagopalan S, Reitsma M, Ribeiro ALP, Rigotti N, Rodgers A, Sable C, Shakil S, Sliwa-Hahnle K, Stark B, Sundström J, Timpel P, Tleyjeh IM, Valgimigli M, Vos T, Whelton PK, Yacoub M, Zuhlke L, Murray C, Fuster V. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol 2020; 76:2982-3021. [PMID: 33309175 PMCID: PMC7755038 DOI: 10.1016/j.jacc.2020.11.010] [Citation(s) in RCA: 3790] [Impact Index Per Article: 947.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 02/07/2023]
Abstract
Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
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Affiliation(s)
| | - George A Mensah
- National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland, USA.
| | - Catherine O Johnson
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | | | - Enrico Ammirati
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy
| | | | - Noël C Barengo
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | | | - Emelia J Benjamin
- Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Aimé Bonny
- District Hospital of Bonassama-University of Douala, Douala, Cameroon
| | - Michael Brauer
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | - Sumeet S Chugh
- Cedars-Sinai, Smidt Heart Institute, Los Angeles, California, USA
| | | | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michael Criqui
- University of California at San Diego, San Diego, California, USA
| | - Nicole DeCleene
- The University of Michigan Samuel and Jean Frankel Cardiovascular Center, Ann Arbor, Michigan, USA
| | - Kim A Eagle
- The University of Michigan Samuel and Jean Frankel Cardiovascular Center, Ann Arbor, Michigan, USA
| | - Sophia Emmons-Bell
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | | | | | - Gerry Fowkes
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - Scott M Grundy
- University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Feng J He
- Queen Mary University of London, London, United Kingdom
| | - George Howard
- University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Frank Hu
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lesley Inker
- Tufts Medical Center, Boston, Massachusetts, USA
| | - Ganesan Karthikeyan
- Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | | | - Walter Koroshetz
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Carl Lavie
- Ochsner Health, New Orleans, Louisiana, USA
| | - Donald Lloyd-Jones
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Hong S Lu
- University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Antonio Mirijello
- IRCCS Casa Sollievo della Sofferenza Hospital, Department of Medical Sciences, San Giovanni Rotondo, Italy
| | - Awoke Misganaw Temesgen
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | - Ali Mokdad
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | - Andrew E Moran
- Columbia University Irving Medical Center, New York, New York, USA
| | - Paul Muntner
- University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bruce Neal
- The University of Sydney School of Medicine, Sydney, New South Wales, Australia
| | | | | | | | | | - Michael Pratt
- University of California at San Diego, San Diego, California, USA
| | - Sanjay Rajagopalan
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Marissa Reitsma
- Stanford University School of Medicine, Stanford, California, USA
| | | | - Nancy Rigotti
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anthony Rodgers
- The George Institute for Global Health, Newtown, New South Wales, Australia; Imperial College of London, London, United Kingdom
| | - Craig Sable
- Children's National Hospital, Washington, DC, USA
| | - Saate Shakil
- University of Washington, Seattle, Washington, USA
| | | | | | | | | | | | | | - Theo Vos
- University of Washington, Seattle, Washington, USA
| | - Paul K Whelton
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Magdi Yacoub
- Imperial College of London, London, United Kingdom
| | - Liesl Zuhlke
- University of Cape Town, Cape Town, South Africa
| | - Christopher Murray
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA
| | - Valentin Fuster
- Icahn School of Medicine at Mount Sinai, New York, New York, USA; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
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Jivanji D, Jamieson S, Mallory C, Wong V, Barrau S, Atri E, Castro G, Barengo NC, Nieder AM. The Association Between Race and 5-year Survival in Patients With Clear Cell Renal Cell Carcinoma: A Cohort Study. Urology 2020; 148:185-191. [PMID: 33285213 DOI: 10.1016/j.urology.2020.10.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/13/2020] [Accepted: 10/18/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine if race was associated with 5-year cause-specific survival in patients with clear cell renal cell carcinoma. MATERIALS AND METHODS Outcomes were investigated using the Surveillance Epidemiology and End Results database with data from 13 states between the years 2007-2015. Covariates included age, sex, insurance, marital status, and tumor stage at diagnosis. Patients <18 years old or with missing data for race, survival time or insurance status were excluded. Cox regression models were used to determine associations through hazard ratios (HR) with 95% confidence intervals (CI) and to adjust for covariates. RESULTS A total of 8421 subjects were included in the analysis. After adjustment, there was no association between race and 5-year cause-specific survival in patients with ccRCC (Black- HR: 0.96, 95%CI: 0.83,1.12; American Indian/Alaskan- HR: 1.01, 95%CI: 0.75,1.36; Asian Pacific Islander- HR: 0.99, 95%CI: 0.82,1.12). Older individuals and those with regional or distant tumors showed an increased hazard of death, while females and insured patients showed decreased hazard. CONCLUSION Our study found that race was not associated with 5-year cause-specific survival from clear cell renal cell carcinoma. However inferior overall survival in Blacks with RCC has been well demonstrated in the literature. Our findings suggest that differences in survival may not be driven by cause-specific factors such as renal cell carcinoma, but rather social determinants of health which disproportionality affect Black patients. Further studies with more power that incorporate information on income, comorbidities, education status, and access to care are therefore necessary.
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Affiliation(s)
- Dhaval Jivanji
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL.
| | - Scott Jamieson
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Chase Mallory
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Vivian Wong
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Sidney Barrau
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Elias Atri
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Alan M Nieder
- Columbia University Division of Urology, Mount Sinai Medical Center, FL
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Martinez-Harvell G, Goluboff F, Rodriguez P, Castro G, Barengo NC. Predictors of adherence to physical activity guidelines in patients with diabetes mellitus in the US in 2017: An exploratory analysis. Prim Care Diabetes 2020; 14:645-653. [PMID: 32561381 DOI: 10.1016/j.pcd.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/26/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Abstract
AIMS To identify if there is an association between socio-economic or demographic factors, lifestyle habits, or chronic conditions and meeting the current exercise recommendations for adult patients with Diabetes Mellitus 2 in the United States. METHODS This secondary analysis of a cross sectional study used data from participants who reported having diabetes and answered questions regarding physical activity in the 2017 Behavioral Risk Factor Surveillance System survey (n=37,204; 42% women; 30%<60 years-of-age). Respondents were dichotomized according to physical activity adherence. Predictors tested included socioeconomic and demographic characteristics, lifestyle habits, and chronic conditions. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Our data showed that 46.5% of participants with diabetes adhered to the physical activity guidelines. Daily smokers were 25% less likely to adhere to the physical activity recommendations (95% CI 0.59-0.95), patients with obesity were 37% less likely (95% CI 0.53-0.74), and those with chronic kidney disease were 24% (95% CI 0.61-0.94) less likely to do so. The odds of adhering to exercise guidelines were reduced by 20% (95% CI 0.70-0.92), 42% (95% CI 0.49-0.68), and 47% (95% CI 0.32-0.57) in good, fair, and poor health respectively. CONCLUSION Patients with poor health, daily smoking, obesity, or kidney disease may benefit from targeted interventions to accomplish their physical activity recommendations.
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Affiliation(s)
- Greisy Martinez-Harvell
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Florencia Goluboff
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
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Bahijri S, Al‐Raddadi R, Ajabnoor G, Jambi H, Al Ahmadi J, Borai A, Barengo NC, Tuomilehto J. Dysglycemia risk score in Saudi Arabia: A tool to identify people at high future risk of developing type 2 diabetes. J Diabetes Investig 2020; 11:844-855. [PMID: 31957345 PMCID: PMC7378422 DOI: 10.1111/jdi.13213] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/29/2022] Open
Abstract
AIMS/INTRODUCTION To develop a non-invasive risk score to identify Saudis having prediabetes or undiagnosed type 2 diabetes. METHODS Adult Saudis without diabetes were recruited randomly using a stratified two-stage cluster sampling method. Demographic, dietary, lifestyle variables, personal and family medical history were collected using a questionnaire. Blood pressure and anthropometric measurements were taken. Body mass index was calculated. The 1-h oral glucose tolerance test was carried out. Glycated hemoglobin, fasting and 1-h plasma glucose were measured, and obtained values were used to define prediabetes and type 2 diabetes (dysglycemia). Logistic regression models were used for assessing the association between various factors and dysglycemia, and Hosmer-Lemeshow summary statistics were used to assess the goodness-of-fit. RESULTS A total of 791 men and 612 women were included, of whom 69 were found to have diabetes, and 259 had prediabetes. The prevalence of dysglycemia was 23%, increasing with age, reaching 71% in adults aged ≥65 years. In univariate analysis age, body mass index, waist circumference, use of antihypertensive medication, history of hyperglycemia, low physical activity, short sleep and family history of diabetes were statistically significant. The final model for the Saudi Diabetes Risk Score constituted sex, age, waist circumference, history of hyperglycemia and family history of diabetes, with the score ranging from 0 to 15. Its fit based on assessment using the receiver operating characteristic curve was good, with an area under the curve of 0.76 (95% confidence interval 0.73-0.79). The proposed cut-point for dysglycemia is 5 or 6, with sensitivity and specificity being approximately 0.7. CONCLUSION The Saudi Diabetes Risk Score is a simple tool that can effectively distinguish Saudis at high risk of dysglycemia.
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Affiliation(s)
- Suhad Bahijri
- Department of Clinical BiochemistryFaculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
- Saudi Diabetes Study Research GroupKing Fahd Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Rajaa Al‐Raddadi
- Saudi Diabetes Study Research GroupKing Fahd Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
- Department of Community MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Ghada Ajabnoor
- Department of Clinical BiochemistryFaculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
- Saudi Diabetes Study Research GroupKing Fahd Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Hanan Jambi
- Saudi Diabetes Study Research GroupKing Fahd Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
- Department of Food and NutritionFaculty of Human Sciences and DesignFaculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Jawaher Al Ahmadi
- Saudi Diabetes Study Research GroupKing Fahd Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
- Department of Family MedicineFaculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Anwar Borai
- Saudi Diabetes Study Research GroupKing Fahd Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
- King Abdullah International Medical Research Center (KAIMRC)College of MedicineKing Saud Bin Abdulaziz University for Health Sciences (KSAU‐HS)JeddahSaudi Arabia
| | - Noël C Barengo
- Department of Medical and Population Health Sciences ResearchHerbert Wertheim College of MedicineFlorida International UniversityMiamiFloridaUSA
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
- Faculty of MedicineRiga Stradins UniversityRigaLatvia
| | - Jaakko Tuomilehto
- Saudi Diabetes Study Research GroupKing Fahd Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
- Department of Public Health SolutionsNational Institute for Health and WelfareHelsinkiFinland
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Carrillo-Larco RM, Albitres-Flores L, Barengo NC, Bernabe-Ortiz A. The association between serum lipids and risk of premature mortality in Latin America: a systematic review of population-based prospective cohort studies. PeerJ 2019; 7:e7856. [PMID: 31592360 PMCID: PMC6779113 DOI: 10.7717/peerj.7856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/09/2019] [Indexed: 12/11/2022] Open
Abstract
Objective To synthetize the scientific evidence on the association between serum lipids and premature mortality in Latin America (LA). Methods Five data bases were searched from inception without language restrictions: Embase, Medline, Global Health, Scopus and LILACS. Population-based studies following random sampling methods were identified. The exposure variable was lipid biomarkers (e.g., total, LDL- or HDL- cholesterol). The outcome was all-cause and cause-specific mortality. The risk of bias was assessed following the Newcastle-Ottawa criteria. Results were summarized qualitatively. Results The initial search resulted in 264 abstracts, five (N = 27,903) were included for the synthesis. Three papers reported on the same study from Puerto Rico (baseline in 1965), one was from Brazil (1996) and one from Peru (2007). All reports analysed different exposure variables and used different risk estimates (relative risks, hazard ratios or odds ratios). None of the reviewed reports showed strong association between individual lipid biomarkers and all-cause or cardiovascular mortality. Conclusion The available evidence is outdated, inconsistently reported on several lipid biomarker definitions and used different methods to study the long-term mortality risk. These findings strongly support the need to better ascertain the mortality risk associated with lipid biomarkers in LA.
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Affiliation(s)
- Rodrigo M Carrillo-Larco
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.,CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Centro de Estudios de Población, Universidad Católica los Ángeles de Chimbote (ULADECH-Católica), Chimbote, Peru
| | - Leonardo Albitres-Flores
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Peru.,Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo-SOCEMUNT, Trujillo, Peru
| | - Noël C Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, United States of America.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Faculty of Medicine, Rı¯ga Stradiņš University (RSU), Riga, Latvia
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Universidad Científica del Sur, Lima, Peru
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Karic S, DesRosiers M, Mizrahi B, Zevallos J, Rodriguez P, Barengo NC. The association between attention deficit hyperactivity disorder severity and risk of mild traumatic brain injury in children with attention deficit hyperactivity disorder in the United States of America: A cross-sectional study of data from the National Survey of Children with Special Health Care Needs. Child Care Health Dev 2019; 45:688-693. [PMID: 31049988 DOI: 10.1111/cch.12684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND As children with attention deficit hyperactivity disorder (ADHD) have shown to be at higher risk of accidents and injury, one may assume that they may also bear a higher likelihood of mild traumatic brain injuries (mTBI). However, the current scientific evidence whether ADHD severity is associated with traumatic brain injuries is controversial. The objective of this study was too assess the association between the severity of ADHD and prevalence of mTBI in 0- to 18-year-old children with ADHD in the United States. METHODS Cross-sectional study using secondary data gathered in 2009/10 from the National Survey of Children with Special Healthcare Needs. After excluding comorbidity and those with nonspecific attention deficits, the final study population consisted of 10,739 children with ADHD from 40,052 households. The main exposure variable was self-reported ADHD severity (mild, moderate, or severe). The main outcome was mTBI, defined as head injury, traumatic brain injury, and/or concussion). Covariates included age, gender and race, medication status. Unadjusted and adjusted logistic regression analysis were used. RESULTS Children with more severe ADHD had consistently increased incidences of mTBI. Adjusted logistic regression analysis revealed a statistically significant association between severity of ADHD and occurrence of mTBI. The corresponding odds ratios were 1.57 (95% confidence interval (CI) [1.13, 2.18] for moderate, and 1.79 (95% CI [1.18, 2.72]) for severe ADHD, respectively, compared with mild ADHD. In males, children with moderate and severe ADHD had increased odds of mTBI. The corresponding odds ratio for mTBI in those with moderate ADHD was 1.60 (95% CI [1.07, 2.39]) and 1.86 (95% CI [1.15, 3.00]) for severe ADHD, respectively. No associations between severity and mTBI were found in girls. CONCLUSIONS As ADHD severity was associated with incidence of mTBI, it is important to identify those who need increased attention and counselling to prevent injury.
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Affiliation(s)
- Semir Karic
- Department of Medical and Population Health Sciences Research, Florida International University Herbert Wertheim College of Medicine, Miami, Florida
| | - Michael DesRosiers
- Department of Medical and Population Health Sciences Research, Florida International University Herbert Wertheim College of Medicine, Miami, Florida
| | - Briana Mizrahi
- Department of Medical and Population Health Sciences Research, Florida International University Herbert Wertheim College of Medicine, Miami, Florida
| | - Juan Zevallos
- Department of Medical and Population Health Sciences Research, Florida International University Herbert Wertheim College of Medicine, Miami, Florida
| | - Pura Rodriguez
- Department of Medical and Population Health Sciences Research, Florida International University Herbert Wertheim College of Medicine, Miami, Florida
| | - Noël C Barengo
- Department of Medical and Population Health Sciences Research, Florida International University Herbert Wertheim College of Medicine, Miami, Florida
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Tran H, Shringarpure N, Ceballos N, Castro G, Rodríguez de la Vega P, Rodriguez J, Barengo NC. Impact of High Body Mass Index on Outcomes of Laparoscopic Hysterectomy. J Gynecol Surg 2019. [DOI: 10.1089/gyn.2019.0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Ha Tran
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Natalia Shringarpure
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Natalie Ceballos
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Grettel Castro
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Pura Rodríguez de la Vega
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Jaime Rodriguez
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Noël C. Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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Carrillo-Larco RM, Barengo NC, Albitres-Flores L, Bernabe-Ortiz A. The risk of mortality among people with type 2 diabetes in Latin America: A systematic review and meta-analysis of population-based cohort studies. Diabetes Metab Res Rev 2019; 35:e3139. [PMID: 30761721 DOI: 10.1002/dmrr.3139] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/06/2019] [Accepted: 02/11/2019] [Indexed: 12/16/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with a high mortality risk, although the magnitude of this association remains unknown in Latin America (LA). We aimed to assess the strength of the association between T2DM and all-cause and cause-specific mortality in population-based cohort studies in LA. Systematic review and meta-analysis: inclusion criteria were (1) men and women 18 years old and above with T2DM; (2) study outcomes all-cause and/or cause-specific mortality; and (3) using people without T2DM as comparison group. Five databases (Scopus, Medline, Embase, Global Health, and LILACS) were searched. Risk of bias was evaluated with the ROBINS-I criteria. Initially, there were 979 identified studies, of which 17 were selected for qualitative synthesis; 14 were included in the meta-analysis (N = 416 821). Self-reported T2DM showed a pooled relative risk (RR) of 2.49 for all-causes mortality (I-squared [I2 ] = 85.7%, p < 0.001; 95% confidence interval [CI], 1.96-3.15). T2DM based on a composite definition was associated with a 2.26-fold higher all-cause mortality (I2 = 93.9%, p < 0.001; 95% CI, 1.36-3.74). The pooled risk estimates were similar between men and women, although higher at younger ages. The pooled RR for cardiovascular mortality was 2.76 (I2 = 59.2%; p < 0.061; 95% CI, 1.99-3.82) and for renal mortality 15.85 (I2 = 0.00%; p < 0.645; 95% CI, 9.82-25.57). Using available population-based cohort studies, this work has identified and estimated the strength of the association between T2DM and mortality in LA. The higher mortality risk compared with high-income countries deserves close attention from health policies makers and clinicians to improve diabetes care and control hence preventing complications and delaying death.
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Affiliation(s)
- Rodrigo M Carrillo-Larco
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Noël C Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Leonardo Albitres-Flores
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Peru
- Sociedad Cientifica de Estudiantes de Medicina de la Universidad Nacional de Trujillo-SOCEMUNT, Trujillo, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
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Barengo NC, Antikainen R, Harald K, Jousilahti P. Smoking and cancer, cardiovascular and total mortality among older adults: The Finrisk Study. Prev Med Rep 2019; 14:100875. [PMID: 31061784 PMCID: PMC6488533 DOI: 10.1016/j.pmedr.2019.100875] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 04/17/2019] [Accepted: 04/22/2019] [Indexed: 12/03/2022] Open
Abstract
Little information is available about the deleterious effect of smoking in older adults The objective of this study was to assess the relationship of smoking habits with cancer, CVD and all-cause mortality in late middle-age (45–64 years) and older (65–74) people. This cohort study of 6516 men and 6514 women studied the relationship of smoking habits with cancer, cardiovascular disease (CVD) and all-cause mortality among middle-aged and older Finnish men and women during 1997–2013. The study cohort was followed up until the end of 2013 (median follow-up time was 11.8 years). Mortality data were obtained from the National Causes of Death Register and data on incident stroke events from the National Hospital Discharge Register. Adjusted Hazard ratios (HR) for total mortality were 2.61 (95% Confidence interval 2.15–3.18) among 45–64 years-old men and 2.59 (2.03–3.29) in 65–74 years-old men. The corresponding HRs for women 45–64 years-of-age were 3.21 (2.47–4.19) and 3.12 (2.09–4.68) for those 65–74 years-old, respectively. Adjusted HRs for CVD mortality in the 45–64 years-old and 65–74 years-old groups were 2.67 (1.92–2.67) and 1.95 (1.33–2.86) in men, and 4.28 (2.29–7.99) and 2.67 (1.28–5.58) in women, respectively. Among men, the risk difference between never and current smokers was 108/100.000 in the age-group 45–64 years, and 324/100.000 in the age group 65–74 years. Among women the differences were 52/100.000 and 196/100.000, respectively. In conclusion, absolute risk difference between never and current smokers are larger among the older age group. Smoking cessation counseling should routinely target also older adults in primary health-care.
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Affiliation(s)
- Noël C. Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, USA
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Corresponding author at: Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
- Oulu City Hospital, Oulu, Finland
| | - Kennet Harald
- Public Health Solutions Department, National Institute for Health and Welfare (THL)
| | - Pekka Jousilahti
- Public Health Solutions Department, National Institute for Health and Welfare (THL)
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Kim H, He Y, Pham R, Ravelo GJ, Rojas P, Rodriguez P, Castro G, Barengo NC, Acuña JM, Cyrus E. Analyzing the Association Between Depression and High-Risk Sexual Behavior Among Adult Latina Immigrant Farm Workers in Miami-Dade County. Int J Environ Res Public Health 2019; 16:ijerph16071120. [PMID: 30925797 PMCID: PMC6480099 DOI: 10.3390/ijerph16071120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 12/31/2022]
Abstract
Latinas are often more affected by HIV due to their socio-economic and demographic profiles and are also less likely to receive proper mental health care. Latina immigrants are often even more vulnerable due to socio-economic and cultural factors that place them at higher risk. The current study seeks to examine the association between depression and risky sexual behaviors among adult Latina immigrants from a farm working community in South Miami-Dade County, (Florida, USA). Cross-sectional secondary data analysis was used for responses from a community-based participatory research (CBPR) study. Out of 234 Latina immigrants, 15% reported being depressed and 80% were reported as having engaged in risky sexual behavior. Although no association was found between depression and high-risk sexual behavior, significant secondary findings present associations between risky sexual behavior and low sexual relationship power, interpersonal violence, and relationship status. Implications for future research on depression and risky sexual behaviors among this population are discussed.
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Affiliation(s)
- Hyunjean Kim
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, FL, USA.
| | - Yingxin He
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, FL, USA.
| | - Ryan Pham
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, FL, USA.
| | - Gira J Ravelo
- Center for Research on US Latino HIV/AIDS and Drug Abuse, Florida International University, Miami 33199, FL, USA.
| | - Patria Rojas
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work. Center for Research on US Latino HIV/AIDS and Drug Abuse, Florida International University, Miami 33199, FL, USA.
| | - Pura Rodriguez
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, FL, USA.
| | - Grettel Castro
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, FL, USA.
| | - Noël C Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, FL, USA.
| | - Juan M Acuña
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami 33199, FL, USA.
| | - Elena Cyrus
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work. Center for Research on US Latino HIV/AIDS and Drug Abuse, Florida International University, Miami 33199, FL, USA.
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Ramirez E, Morano J, Beguiristain T, Castro G, de la Vega PR, Nieder AM, Barengo NC. Insurance status as a modifier of the association between race and stage of prostate cancer diagnosis in Florida during 1995 and 2013. Cancer Epidemiol 2019; 59:104-108. [PMID: 30731402 DOI: 10.1016/j.canep.2019.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cancer stage at diagnosis is a critical prognostic factor regarding a patient's health outcomes. It has yet to be shown whether insurance status across different race has any implications on the stage of disease at the time of diagnosis. This study aimed to investigate whether insurance status was a modifier of the association between race and stage of previously undetected prostate cancer at the time of diagnosis in Florida between 1995 and 2013. METHODS Secondary data analysis of a cross-sectional survey using information from the Florida Cancer Data System (n = 224,819). Study participants included black and white males diagnosed with prostate cancer in Florida between 1995 and 2013. The main outcome variable was stage of prostate cancer at diagnosis. The main independent variable was race (black vs white). Adjusted logistic regression models were used to explore the association between race, insurance status and stage at diagnosis. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. RESULTS Black males were more likely to be diagnosed with late stage prostate cancer (OR 1.31; 95% CI 1.27-1.35). Being uninsured (OR 2.28; 95% CI 2.13-2.45) or having Medicaid (OR 1.84; 95% CI 1.70-1.98) was associated with a diagnosis of late stage cancer. Stratified analysis for health insurance revealed that blacks had an increased risk for late stage cancer if uninsured (OR 1.29; 95% CI 1.07-1.55) and if having Medicare (OR 1.39; 95% CI 1.31-1.48). CONCLUSION Insurance status may modify the effect of race on late stage prostate cancer in black patients.
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Affiliation(s)
- Evelyn Ramirez
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States
| | - Julieta Morano
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States
| | - Tiffany Beguiristain
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States
| | - Grettel Castro
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States
| | - Pura Rodriguez de la Vega
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States
| | - Alan M Nieder
- Department of Urology, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States
| | - Noël C Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, United States.
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Alshareef SH, Alsobaie NA, Aldeheshi SA, Alturki ST, Zevallos JC, Barengo NC. Association between Race and Cancer-Related Mortality among Patients with Colorectal Cancer in the United States: A Retrospective Cohort Study. Int J Environ Res Public Health 2019; 16:ijerph16020240. [PMID: 30654462 PMCID: PMC6352187 DOI: 10.3390/ijerph16020240] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/04/2019] [Accepted: 01/14/2019] [Indexed: 12/24/2022]
Abstract
Colorectal cancer (CRC) is the third most common cause of mortality in the United States (US). Differences in CRC mortality according to race have been extensively studied; however, much more understanding with regard to tumor characteristics’ effect on mortality is needed. The objective was to investigate the association between race and mortality among CRC patients in the US during 2007–2014. A retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) Program, which collects cancer statistics through selected population-based cancer registries during in the US, was conducted. The outcome variable was CRC-related mortality in adult patients (≥18 years old) during 2007–2014. The independent variable was race of white, black, Asian/Pacific Islander (API), and American Indian/Alaska Native (others). The covariates were, age, sex, marital status, health insurance, tumor stage at diagnosis, and tumor size and grade. Bivariate analysis was performed to identify possible confounders (chi-square tests). Unadjusted and adjusted logistic regression models were used to study the association between race and CRC-specific mortality. The final number of participants consisted of 70,392 patients. Blacks had a 32% higher risk of death compared to whites (adjusted odds ratio (OR) 1.32; 95% confidence interval (CI) 1.22–1.43). Corresponding OR for others were 1.41 (95% CI 1.10–1.84). API had nonsignificant adjusted odds of mortality compared to whites (0.95; 95% CI 0.87–1.03). In conclusion, we observed a significant increased risk of mortality in black and American Indian/Alaska Native patients with CRC compared to white patients.
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Affiliation(s)
- Sayaf H Alshareef
- College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia.
| | - Nasser A Alsobaie
- College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia.
| | - Salman A Aldeheshi
- College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia.
| | - Sultan T Alturki
- College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh 13317, Saudi Arabia.
| | - Juan Carlos Zevallos
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
| | - Noël C Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.
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Alkandari A, Longenecker JC, Barengo NC, Alkhatib A, Weiderpass E, Al-Wotayan R, Al Duwairi Q, Tuomilehto J. The prevalence of pre-diabetes and diabetes in the Kuwaiti adult population in 2014. Diabetes Res Clin Pract 2018; 144:213-223. [PMID: 30179683 DOI: 10.1016/j.diabres.2018.08.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Kuwait ranks among the top 20 countries worldwide in diabetes prevalence. This study's objectives were to assess the prevalence of pre-diabetes and diabetes in Kuwaiti adults. METHODS Kuwaiti citizens aged 18-69 years (n = 3915) were studied using the WHO's STEPwise survey methodology, including its Instrument for Chronic Disease Risk Factor Surveillance. Participants' demographics, medical history, physical measurements and blood biochemistry were assessed. A subset of 2561 individuals completed all three survey steps, including fasting plasma glucose (FPG) and HbA1c assays. The study assessed the prevalence of pre-diabetes (FPG 6.1-6.9 mmol/L or HbA1c level 5.7-6.4%) and diabetes (self-reported history of diabetes with prescription of diabetes medications or FPG ≥ 7 mmol/L or HbA1c level ≥6.5%). RESULTS The prevalence of pre-diabetes was 19.4% [95% CI: 17.9-21.0%] (By sex: Men, 19.3%; Women, 19.5%; p = 0.92; By age (years): 18-29 y, 13.9%; 30-44 y, 22.6%; 45-59 y, 25.8%; 60-69 y, 16.4%; p < 0.001). The prevalence of diabetes was 18.8% [17.3-20.4%] (By sex: Men, 20.4%; Women, 17.4%; p = 0.055; By age: 18-29 y, 6.6%; 30-44 y, 14.0%; 45-59 y, 36.7%; 60-69 y, 62.8%; p < 0.001), of whom 41.5% were previously undiagnosed. Diabetes prevalence was 27.4% among those with body mass index (BMI) ≥ 30 kg/m2, 29% among those with elevated waist-hip ratio and 36% among those with hypertension. Diabetes was positively associated with BMI, waist-hip ratio and blood pressure level. Pre-diabetes was positively associated with BMI and waist-hip ratio, but not blood pressure level. CONCLUSIONS Almost 40% of Kuwaiti citizens had pre-diabetes or diabetes. Urgent public health action is needed to decrease diabetes prevalence and thus avoid associated morbidity and mortality.
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Affiliation(s)
| | | | - Noël C Barengo
- Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, USA
| | | | - Elisabete Weiderpass
- Dasman Diabetes Institute, Kuwait City, Kuwait; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
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