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Guzman-Gomez A, Ahmed H, Lehenbauer D, Morales D, Critser P, Hirsch R, Zafar F, Hayes D. Lung Transplant Outcomes in Young Adults with Pulmonary Hypertension Bridged with ECMO. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1028] [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: 04/05/2023] Open
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Guzman-Gomez A, Ahmed H, Lehenbauer D, Morales D, Critser P, Hirsch R, Zafar F, Hayes D. Outcomes of ECMO as Bridge to Lung Transplant in Children with Pulmonary Hypertension. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.416] [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: 04/05/2023] Open
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McGovern E, Alsaied T, Szugye N, Pradhan S, Batlivala SP, Lubert A, Hirsch R. The Fontan Pathway: Change in Dimension and Catheter-Based Intervention over Time. Pediatr Cardiol 2021; 42:1740-1748. [PMID: 34136951 DOI: 10.1007/s00246-021-02658-2] [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: 04/14/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
An unobstructed Fontan pathway is essential for optimal hemodynamics. We hypothesize that more extracardiac conduit (ECC) Fontan pathways develop obstruction compared to lateral tunnel (LT) Fontans and that the dilation typically observed in LTs results in similar mid-term clinical outcomes. A single-center, retrospective study was done including all Fontan cardiac catheterizations from 2006 to 2019. Angiography and medical records were reviewed to define Fontan pathway dimensions, interventions, and clinical outcomes. 232 patients underwent cardiac catheterization, where 60% were ECCs and 30% LTs. The minimum cross-sectional area (CSA) of ECCs was significantly smaller than LTs and LTs dilated over time. 13% of patients had Fontan pathway stenting at a median age of 16.2 years. The minimum CSA for patients who underwent intervention was significantly smaller than patients who did not. Lower weight at Fontan surgery was associated with intervention on the Fontan pathway, with a threshold weight of 15 kg for patients with an ECC. The median follow-up was 3.3 years. Patients who had Fontan pathway intervention were not more likely to experience the composite adverse clinical outcome. LTs were more likely than ECCs to have worse clinical outcome, when liver fibrosis was included. This is the first study to describe angiographic dimensions of the Fontan pathway in a large number of patients over time. ECCs tend to become stenotic. Lower weight at Fontan surgery is a potential risk for Fontan pathway intervention. LTs may experience worse clinical outcomes in follow-up. This information can help inform the optimal timing and method of post-Fontan surveillance.
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Affiliation(s)
- E McGovern
- Division of Pediatric Cardiology, Department of Pediatrics, University of Kentucky, Lexington, KY, USA.
| | - T Alsaied
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - N Szugye
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S Pradhan
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S P Batlivala
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A Lubert
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Hirsch
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Thangappan K, Guzman-Gomez A, Zafar F, Hirsch R, Shahanavaz S, Schecter M, Hayes D, Morales D. To Cath or Not to Cath: Pediatric Lung Transplant Candidates without a Diagnosis of Pulmonary Hypertension. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.992] [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: 10/21/2022] Open
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Dani A, Hayes D, Woods J, Morales D, Hirsch R, Zafar F, Hysinger E. Lung Transplantation for Bronchopulmonary Dysplasia: An Analysis of the UNOS Registry. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.494] [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] Open
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Crowder‐Martin T, Richard P, Hirsch R. The Influence of Veterans Affairs' Full Practice Authority Policy Change on Access to Primary Health care. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13431] [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] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - P. Richard
- Uniformed Services University of the Health Sciences Bethesda MD United States
| | - R. Hirsch
- Stat‐Aid Consulting Overland Park KS United States
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Thangappan K, Price N, Zafar F, Alsaied T, Hirsch R, Schecter M, Morales D. Congenital Heart Disease and a Single Lung: Is Heart Transplantation Alone an Option? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.821] [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: 10/24/2022] Open
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Geese M, Ermann M, Schneider M, Monecke S, Kaever A, Frankenreiter S, Bayerlova M, Schreiter K, Dickie A, Loke P, James T, Anighoro A, Hirsch R, Müller S, De Maeyer J. P.42Discovery of novel small molecule treatment options for FSHD. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.071] [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: 10/25/2022]
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Rosiak D, Seidlitz M, Reiter P, Naïdja H, Tsunoda Y, Togashi T, Nowacki F, Otsuka T, Colò G, Arnswald K, Berry T, Blazhev A, Borge MJG, Cederkäll J, Cox DM, De Witte H, Gaffney LP, Henrich C, Hirsch R, Huyse M, Illana A, Johnston K, Kaya L, Kröll T, Benito MLL, Ojala J, Pakarinen J, Queiser M, Rainovski G, Rodriguez JA, Siebeck B, Siesling E, Snäll J, Van Duppen P, Vogt A, von Schmid M, Warr N, Wenander F, Zell KO. Enhanced Quadrupole and Octupole Strength in Doubly Magic ^{132}Sn. Phys Rev Lett 2018; 121:252501. [PMID: 30608829 DOI: 10.1103/physrevlett.121.252501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/14/2018] [Indexed: 06/09/2023]
Abstract
The first 2^{+} and 3^{-} states of the doubly magic nucleus ^{132}Sn are populated via safe Coulomb excitation employing the recently commissioned HIE-ISOLDE accelerator at CERN in conjunction with the highly efficient MINIBALL array. The ^{132}Sn ions are accelerated to an energy of 5.49 MeV/nucleon and impinged on a ^{206}Pb target. Deexciting γ rays from the low-lying excited states of the target and the projectile are recorded in coincidence with scattered particles. The reduced transition strengths are determined for the transitions 0_{g.s.}^{+}→2_{1}^{+}, 0_{g.s.}^{+}→3_{1}^{-}, and 2_{1}^{+}→3_{1}^{-} in ^{132}Sn. The results on these states provide crucial information on cross-shell configurations which are determined within large-scale shell-model and Monte Carlo shell-model calculations as well as from random-phase approximation and relativistic random-phase approximation. The locally enhanced B(E2;0_{g.s.}^{+}→2_{1}^{+}) strength is consistent with the microscopic description of the structure of the respective states within all theoretical approaches. The presented results of experiment and theory can be considered to be the first direct verification of the sphericity and double magicity of ^{132}Sn.
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Affiliation(s)
- D Rosiak
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - M Seidlitz
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - P Reiter
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - H Naïdja
- Université de Strasbourg, IPHC, 23 rue du Loess, F-67037 Strasbourg, France
- CNRS, UMR 7178, F-67037 Strasbourg, France
- Université Constantine 1, LPMS, route Ain El Bey, DZ-25000 Constantine, Algeria
| | - Y Tsunoda
- Center for Nuclear Study, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - T Togashi
- Center for Nuclear Study, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - F Nowacki
- Université de Strasbourg, IPHC, 23 rue du Loess, F-67037 Strasbourg, France
- CNRS, UMR 7178, F-67037 Strasbourg, France
| | - T Otsuka
- Center for Nuclear Study, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Department of Physics, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Instituut voor Kern- en Stralingsfysica, KU Leuven, Celestijnenlaan 200D, B-3001 Leuven, Belgium
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - G Colò
- Dipartimento di Fisica, Universitò degli Studi di Milano, Via Celoria 16, I-20133 Milano, Italy
- INFN sezione di Milano, Via Celoria 16, I-20133, Milano, Italy
| | - K Arnswald
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - T Berry
- Department of Physics, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - A Blazhev
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - M J G Borge
- ISOLDE, CERN, CH-1211 Geneva 23, Switzerland
| | - J Cederkäll
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - D M Cox
- University of Jyvaskyla, Department of Physics, P. O. Box 35, FI-40014 University of Jyvaskyla, Finland
- Helsinki Institute of Physics, P. O. Box 64, FI-00014 Helsinki, Finland
| | - H De Witte
- Instituut voor Kern- en Stralingsfysica, KU Leuven, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - L P Gaffney
- ISOLDE, CERN, CH-1211 Geneva 23, Switzerland
| | - C Henrich
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, D-64289 Darmstadt, Germany
| | - R Hirsch
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - M Huyse
- Instituut voor Kern- en Stralingsfysica, KU Leuven, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - A Illana
- Instituut voor Kern- en Stralingsfysica, KU Leuven, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - K Johnston
- ISOLDE, CERN, CH-1211 Geneva 23, Switzerland
| | - L Kaya
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - Th Kröll
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, D-64289 Darmstadt, Germany
| | | | - J Ojala
- University of Jyvaskyla, Department of Physics, P. O. Box 35, FI-40014 University of Jyvaskyla, Finland
- Helsinki Institute of Physics, P. O. Box 64, FI-00014 Helsinki, Finland
| | - J Pakarinen
- University of Jyvaskyla, Department of Physics, P. O. Box 35, FI-40014 University of Jyvaskyla, Finland
- Helsinki Institute of Physics, P. O. Box 64, FI-00014 Helsinki, Finland
| | - M Queiser
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - G Rainovski
- Department of Atomic Physics, University of Sofia, 5 James Bourchier Boulevard, BG-1164 Sofia, Bulgaria
| | | | - B Siebeck
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - E Siesling
- ISOLDE, CERN, CH-1211 Geneva 23, Switzerland
| | - J Snäll
- Department of Physics, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - P Van Duppen
- Instituut voor Kern- en Stralingsfysica, KU Leuven, Celestijnenlaan 200D, B-3001 Leuven, Belgium
| | - A Vogt
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - M von Schmid
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, D-64289 Darmstadt, Germany
| | - N Warr
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
| | - F Wenander
- ISOLDE, CERN, CH-1211 Geneva 23, Switzerland
| | - K O Zell
- Institut für Kernphysik, Universität zu Köln, Zülpicher Straße 77, D-50937 Köln, Germany
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Benderly M, Kalter-Leibovici O, Weitzman D, Blieden L, Buber J, Dadashev A, Mazor-Dray E, Lorber A, Nir A, Razon Y, Yalonetsky S, Chodick G, Hirsch R. P2605Depression and anxiety are associated with high healthcare resource utilization among adults with congenital heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2605] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M Benderly
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel
| | - O Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat-Gan, Israel
| | - D Weitzman
- Maccabi Healthcare Services, Morris Kahn & Maccabi institute for research and innovation, Tel Aviv, Israel
| | - L Blieden
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
| | - J Buber
- Chaim Sheba Medical Center, Heart Institute, Tel Hashomer, Israel
| | - A Dadashev
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
| | - E Mazor-Dray
- Ben Gurion University of the Negev, Faculty of Health Sciences, Beer Sheva, Israel
| | - A Lorber
- Rambam Health Care Campus, Pediatric Cardiology and GUCH Unit, Haifa, Israel
| | - A Nir
- Hadassah University Medical Center, Department of Pediatric Cardiology, Jerusalem, Israel
| | - Y Razon
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
| | - S Yalonetsky
- Rambam Health Care Campus, Pediatric Cardiology and GUCH Unit, Haifa, Israel
| | - G Chodick
- Maccabi Healthcare Services, Morris Kahn & Maccabi institute for research and innovation, Tel Aviv, Israel
| | - R Hirsch
- Rabin Medical Center, Adult Congenital Heart Disease Unit, Petach Tikva, Israel
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Rotz SJ, Ryan TD, Jodele S, Jefferies JL, Lane A, Pate A, Hirsch R, Hlavaty J, Levesque AE, Taylor MD, Cash M, Myers KC, El-Bietar JA, Davies SM, Dandoy CE. The injured heart: early cardiac effects of hematopoietic stem cell transplantation in children and young adults. Bone Marrow Transplant 2017; 52:1171-1179. [PMID: 28394368 DOI: 10.1038/bmt.2017.62] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/12/2017] [Accepted: 02/13/2017] [Indexed: 12/25/2022]
Abstract
We hypothesized that subclinical cardiac injury in the peri-transplant period is more frequent than currently appreciated in children and young adults. We performed echocardiographic screening on 227 consecutive patients prior to hematopoietic stem cell transplantation (HSCT), and 7, 30 and 100 days after transplant. We measured cardiac biomarkers cardiac troponin-I (cTn-I), and soluble suppressor of tumorigenicity 2 (sST2) prior to transplant, during conditioning, and days +7, +14, +28 and +49 in 26 patients. We subsequently analyzed levels of cTn-I every 48-72 h in 15 consecutive children during conditioning. Thirty-two percent (73/227) of patients had a new abnormality on echocardiogram. New left ventricular systolic dysfunction (LVSD) occurred in 6.2% of subjects and new pericardial effusion in 27.3%. Eight of 227 (3.5%) patients underwent pericardial drain placement, and 5 (2.2%) received medical therapy for clinically occult LVSD. cTn-I was elevated in 53.0% of all samples and sST2 in 38.2%. At least one sample had a detectable cTn-I in 84.6% of patients and an elevated sST2 in 76.9%. Thirteen of fifteen patients monitored frequently during condition had elevation of cTn-I. Echocardiographic and biochemical abnormalities are frequent in the peri-HSCT period. Echocardiogram does not detect all subclinical cardiac injuries that may become clinically relevant over longer periods.
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Affiliation(s)
- S J Rotz
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - T D Ryan
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S Jodele
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J L Jefferies
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A Lane
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A Pate
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Hirsch
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J Hlavaty
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A E Levesque
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - M D Taylor
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - M Cash
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - K C Myers
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J A El-Bietar
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S M Davies
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - C E Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Pfeiffer TM, Rotz SJ, Ryan TD, Hirsch R, Taylor M, Chima R, Pate A, Hlavaty J, Grimley M, Myers K, El-Bietar J, Davies SM, Jodele S, Dandoy C. Pericardial effusion requiring surgical intervention after stem cell transplantation: a case series. Bone Marrow Transplant 2016; 52:630-633. [PMID: 27991890 DOI: 10.1038/bmt.2016.331] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- T M Pfeiffer
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S J Rotz
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - T D Ryan
- Division of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Hirsch
- Division of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - M Taylor
- Division of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - R Chima
- Division of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A Pate
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J Hlavaty
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - M Grimley
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - K Myers
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J El-Bietar
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S M Davies
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - S Jodele
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - C Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Weeks BK, Hirsch R, Nogueira RC, Beck BR. Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass in children? Bone Joint Res 2016; 5:538-543. [PMID: 27827803 PMCID: PMC5131090 DOI: 10.1302/2046-3758.511.bjr-2016-0116.r1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/07/2016] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of the current study was to assess whether calcaneal broadband ultrasound attenuation (BUA) can predict whole body and regional dual-energy x-ray absorptiometry (DXA)-derived bone mass in healthy, Australian children and adolescents at different stages of maturity. Methods A total of 389 boys and girls across a wide age range (four to 18 years) volunteered to participate. The estimated age of peak height velocity (APHV) was used to classify children into pre-, peri-, and post-APHV groups. BUA was measured at the non-dominant heel with quantitative ultrasonometry (QUS) (Lunar Achilles Insight, GE), while bone mineral density (BMD) and bone mineral content (BMC) were examined at the femoral neck, lumbar spine and whole body (DXA, XR-800, Norland). Associations between BUA and DXA-derived measures were examined with Pearson correlations and linear regression. Participants were additionally ranked in quartiles for QUS and DXA measures in order to determine agreement in rankings. Results For the whole sample, BUA predicted 29% of the study population variance in whole body BMC and BMD, 23% to 24% of the study population variance in lumbar spine BMC and BMD, and 21% to 24% of the variance in femoral neck BMC and BMD (p < 0.001). BUA predictions were strongest for the most mature participants (pre-APHV R2 = 0.03 to 0.19; peri-APHV R2 = 0.05 to 0.17; post-APHV R2 = 0.18 to 0.28) and marginally stronger for girls (R2 = 0.25-0.32, p < 0.001) than for boys (R2 = 0.21-0.27, p < 0.001). Agreement in quartile rankings between QUS and DXA measures of bone mass was generally poor (27.3% to 38.2%). Conclusion Calcaneal BUA has a weak to moderate relationship with DXA measurements of bone mass in children, and has a tendency to misclassify children on the basis of quartile rankings. Cite this article: B. K. Weeks, R. Hirsch, R. C. Nogueira, B. R. Beck. Is calcaneal broadband ultrasound attenuation a valid index of dual-energy x-ray absorptiometry-derived bone mass in children? Bone Joint Res 2016;5:538–543. DOI: 10.1302/2046-3758.511.BJR-2016-0116.R1.
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Affiliation(s)
- B K Weeks
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - R Hirsch
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - R C Nogueira
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - B R Beck
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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Fuller DA, Barrett M, Marburger RK, Hirsch R. Carpal Canal Pressures after Volar Plating of Distal Radius Fractures. ACTA ACUST UNITED AC 2016; 31:236-9. [PMID: 16359764 DOI: 10.1016/j.jhsb.2005.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2005] [Revised: 10/22/2005] [Accepted: 10/27/2005] [Indexed: 11/17/2022]
Abstract
Elevated pressures within the carpal canal are known to occur after distal radius fractures. Controversy exists regarding prophylactic carpal tunnel release after open reduction with internal fixation of distal radius fractures. The purpose of this study was to determine the tissue pressures within the carpal canal after volar plating of distal radius fractures. This study was a prospective, observational, IRB approved research study. Ten consecutive patients undergoing volar plating of distal radius fractures were enrolled. After the distal radius fractures were reduced and fixed with volar plates, slit catheters were inserted into the carpal canals for continuous postoperative pressure monitoring for 24 hours. The maximum recorded pressure was 65 mmHg, which occurred in the only patient with fracture blisters. Peak pressures remained at 40 mmHg or less (range 16–40, mean 29) in all patients without fracture blisters. At the conclusion of data collection, all pressures were at 31 mmHg or less. No patient complained of median nerve dysfunction during the study period. Routine prophylactic carpal tunnel release is not recommended after volar plating of distal radius fractures based on these pressure recordings.
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Affiliation(s)
- D A Fuller
- Department of Surgery, Division of Orthopaedics, University of Medicine and Dentistry of New Jersey, Camden, NJ, USA.
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Faiz A, Donovan C, Nieuwenhuis MA, van den Berge M, Postma DS, Yao S, Park CY, Hirsch R, Fredberg JJ, Tjin G, Halayko AJ, Rempel KL, Ward JPT, Lee T, Bossé Y, Nickle DC, Obeidat M, Vonk JM, Black JL, Oliver BG, Krishnan R, McParland B, Bourke JE, Burgess JK. Latrophilin receptors: novel bronchodilator targets in asthma. Thorax 2016; 72:74-82. [PMID: 27325752 PMCID: PMC5329048 DOI: 10.1136/thoraxjnl-2015-207236] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 05/16/2016] [Accepted: 05/19/2016] [Indexed: 01/30/2023]
Abstract
Background Asthma affects 300 million people worldwide. In asthma, the major cause of morbidity and mortality is acute airway narrowing, due to airway smooth muscle (ASM) hypercontraction, associated with airway remodelling. However, little is known about the transcriptional differences between healthy and asthmatic ASM cells. Objectives To investigate the transcriptional differences between asthmatic and healthy airway smooth muscle cells (ASMC) in culture and investigate the identified targets using in vitro and ex vivo techniques. Methods Human asthmatic and healthy ASMC grown in culture were run on Affymetrix_Hugene_1.0_ST microarrays. Identified candidates were confirmed by PCR, and immunohistochemistry. Functional analysis was conducted using in vitro ASMC proliferation, attachment and contraction assays and ex vivo contraction of mouse airways. Results We suggest a novel role for latrophilin (LPHN) receptors, finding increased expression on ASMC from asthmatics, compared with non-asthmatics in vivo and in vitro, suggesting a role in mediating airway function. A single nucleotide polymorphism in LPHN1 was associated with asthma and with increased LPHN1 expression in lung tissue. When activated, LPHNs regulated ASMC adhesion and proliferation in vitro, and promoted contraction of mouse airways and ASMC. Conclusions Given the need for novel inhibitors of airway remodelling and bronchodilators in asthma, the LPHN family may represent promising novel targets for future dual therapeutic intervention.
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Affiliation(s)
- A Faiz
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - C Donovan
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Department of Pharmacology and Therapeutics, Lung Health Research Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - M Ae Nieuwenhuis
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - M van den Berge
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - D S Postma
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - S Yao
- Center for Vascular Biology Research, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - C Y Park
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - R Hirsch
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - J J Fredberg
- Program in Molecular and Integrative Physiological Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - G Tjin
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia
| | - A J Halayko
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - K L Rempel
- Manitoba Institute of Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - T Lee
- Kings College London, London, UK
| | - Y Bossé
- Department of Molecular Medicine, Institut universitaire de cardiologie et de pneumologie de Québec, Laval University, Québec, Quebec, Canada
| | - D C Nickle
- Merck Research Laboratories, Genetics and Pharmacogenomics, Boston, Massachusetts, USA
| | - M Obeidat
- Centre for Heart Lung Innovation, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Judith M Vonk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - J L Black
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,Discipline of Pharmacology, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - B G Oliver
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,School of Medical and Molecular Biosciences, University of Technology, Sydney, New South Wales, Australia
| | - R Krishnan
- Center for Vascular Biology Research, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - B McParland
- Discipline of Pharmacology, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - J E Bourke
- Department of Pharmacology, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,Department of Pharmacology and Therapeutics, Lung Health Research Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - J K Burgess
- Woolcock Institute of Medical Research, The University of Sydney, Glebe, New South Wales, Australia.,Discipline of Pharmacology, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia.,University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, The Netherlands
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Gomez-Castillo BJ, Hirsch R, Groninger H, Baker K, Cheng MJ, Phillips J, Pollack J, Berger AM. Increasing the Number of Outpatients Receiving Spiritual Assessment: A Pain and Palliative Care Service Quality Improvement Project. J Pain Symptom Manage 2015; 50:724-9. [PMID: 26166183 PMCID: PMC4624036 DOI: 10.1016/j.jpainsymman.2015.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 05/28/2015] [Accepted: 05/31/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Spirituality is a patient need that requires special attention from the Pain and Palliative Care Service team. This quality improvement project aimed to provide spiritual assessment for all new outpatients with serious life-altering illnesses. MEASURES Percentage of new outpatients receiving spiritual assessment (Faith, Importance/Influence, Community, Address/Action in care, psychosocial evaluation, chaplain consults) at baseline and postinterventions. INTERVENTION Interventions included encouraging clinicians to incorporate adequate spiritual assessment into patient care and implementing chaplain covisits for all initial outpatient visits. OUTCOMES The quality improvement interventions increased spiritual assessment (baseline vs. postinterventions): chaplain covisits (25.5% vs. 50%), Faith, Importance/Influence, Community, Address/Action in care completion (49% vs. 72%), and psychosocial evaluation (89% vs. 94%). CONCLUSIONS/LESSONS LEARNED Improved spiritual assessment in an outpatient palliative care clinic setting can occur with a multidisciplinary approach. This project also identifies data collection and documentation processes that can be targeted for improvement.
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Affiliation(s)
- Blanca J Gomez-Castillo
- Georgetown University Medical Center, Washington, DC; Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Rosemarie Hirsch
- Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Hunter Groninger
- Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Karen Baker
- Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - M Jennifer Cheng
- Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Jayne Phillips
- Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - John Pollack
- Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA; Spiritual Care Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Ann M Berger
- Pain and Palliative Care Service, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.
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Doyle CJ, Fitzsimmons TR, Marchant C, Dharmapatni AASSK, Hirsch R, Bartold PM. Azithromycin suppresses P. gingivalis LPS-induced pro-inflammatory cytokine and chemokine production by human gingival fibroblasts in vitro. Clin Oral Investig 2014; 19:221-7. [DOI: 10.1007/s00784-014-1249-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/24/2014] [Indexed: 02/04/2023]
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19
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Lerner D, Dandoy C, Hirsch R, Laskin B, Davies SM, Jodele S. Pericardial effusion in pediatric SCT recipients with thrombotic microangiopathy. Bone Marrow Transplant 2014; 49:862-3. [PMID: 24637900 DOI: 10.1038/bmt.2014.40] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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21
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Curtin LR, Mohadjer LK, Dohrmann SM, Kruszon-Moran D, Mirel LB, Carroll MD, Hirsch R, Burt VL, Johnson CL. National Health and Nutrition Examination Survey: sample design, 2007-2010. Vital Health Stat 2 2013:1-23. [PMID: 25090039] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Data collection for the National Health and Nutrition Examination Survey (NHANES) comprises three levels: a household screener, an interview, and a physical examination. The primary objective of the screener is to determine whether any household members are eligible for the interview an dexamination. Eligibility is determined by preset selection probabilities for the desired demographic subdomains. After an eligible sample person is selected, the interview collects person-level demographic, health, and nutrition information, as well as information about the household. The examination includes physical measurements, tests such as hearing and dental examinations, and the collection of blood and urine specimens for laboratory testing. OBJECTIVES This report provides some background on the NHANES program, beginning with the first survey cycle in the 1970s and highlighting significant changes since its inception. The report then describes the broad design specifications for the 2007-2010 survey cycle, including survey objectives, domain and precision specifications, and operational requirements unique to NHANES. In addition, the report describes the details of the survey design, including the calculation of sampling rates and sample selection methods. Documentation of survey content, data collection procedures, estimation methods, and methods to assess nonsampling errors are reported elsewhere.
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22
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Kuklina EV, Carroll MD, Shaw KM, Hirsch R. Trends in high LDL cholesterol, cholesterol-lowering medication use, and dietary saturated-fat intake: United States, 1976-2010. NCHS Data Brief 2013:1-8. [PMID: 23759124 PMCID: PMC4401469] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
From 1976–1980 through 2007–2010, for U.S. adults aged 40–74, a decrease was observed in the prevalence of high LDL–C, as well as an increase in adults using lipid-lowering medications and consuming a diet low in saturated fat. A substantial decline in the prevalence of high LDL–C from 59% to 28% was seen over this same time period. There also were significant increases in the percentage of adults meeting federal dietary guidelines (6) for low dietary saturated-fat intake, from 25% to 42%, between 1976–1980 and 2007–2010; however, no significant changes were observed from 1988–1994 to 2007–2010. Although declines in the proportion of calories from saturated fat have occurred since the 1970s, the average dietary energy intake has increased (7). Use of cholesterol-lowering medication continued to grow steadily, from 5% to 23%, from 1988–1994 to 2007–2010. Despite recent advances in medical treatment, high cholesterol remains a significant public health problem in the United States, with more than one-quarter of adults aged 40–74 having high LDL–C. These findings may provide useful information for evaluation of programs and policy initiatives aimed at reducing the prevalence of high cholesterol in the adult population.
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Affiliation(s)
- Elena V Kuklina
- Centers for Disease Control and Prevention’s (CDC) National Center for Chronic Disease and Health Promotion, Division for Heart Disease and Stroke Prevention
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23
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Reveille JD, Hirsch R, Dillon CF, Carroll MD, Weisman MH. The prevalence of HLA-B27 in the US: data from the US National Health and Nutrition Examination Survey, 2009. ACTA ACUST UNITED AC 2012; 64:1407-11. [PMID: 22139851 DOI: 10.1002/art.33503] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To carry out the first large-scale population study of the prevalence of HLA-B27 in the US, which is needed for public health planning purposes because of recent improvements in medical therapy and diagnostic testing for ankylosing spondylitis (AS). METHODS The national prevalence of HLA-B27 was determined as part of the 2009 US National Health and Nutrition Examination Survey (NHANES), a cross-sectional survey monitoring the health and nutritional status of the US civilian, noninstitutionalized population. DNA polymerase chain reaction analysis was conducted in samples from 2,320 adults ages 20-69 years from this nationally representative sample. RESULTS The age-adjusted US prevalence of B27 was 6.1% (95% confidence interval [95% CI] 4.6-8.2). By race/ethnicity, the prevalence of B27 was 7.5% (95% CI 5.3-10.4) among non-Hispanic whites and 3.5% (95% CI 2.5-4.8) among all other US races/ethnicities combined. In Mexican Americans, the prevalence was 4.6% (95% CI 3.4-6.1). The prevalence of B27 could not be reliably estimated for other US racial/ethnic groups because of the low number of B27-positive individuals in those groups. For adults 50-69 years of age, the prevalence of B27 was 3.6% (95% CI 2.2-5.8), which suggested a decrease in B27 with age. These prevalence estimates took into account the NHANES survey design and are reviewed with respect to data from the medical literature. CONCLUSION Our findings provide the first US national prevalence estimates for HLA-B27. A decline in the prevalence of HLA-B27 with age is suggested by these data but must be confirmed by additional studies.
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Affiliation(s)
- John D Reveille
- Division of Rheumatology, University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 5.270, Houston, TX 77030, USA.
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Curtin LR, Mohadjer LK, Dohrmann SM, Montaquila JM, Kruszan-Moran D, Mirel LB, Carroll MD, Hirsch R, Schober S, Johnson CL. The National Health and Nutrition Examination Survey: Sample Design, 1999-2006. Vital Health Stat 2 2012:1-39. [PMID: 22788053] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Data collection for the National Health and Nutrition Examination Survey (NHANES) comprises three levels: a household screener, an interview, and a physical examination. The primary objective of the screener is to determine whether any household members are eligible for the interview and examination. Eligibility is determined by the preset selection probabilities for the desired demographic subdomains. After selection as an eligible sample person, the interview collects person-level demographic, health, and nutrition information as well as information about the household. The examination includes physical measurements, tests such as eye and dental examinations, and the collection of blood and urine specimens for laboratory testing. OBJECTIVES This report will first describe the broad design specifications for the 1999-2006 survey including survey objectives, domain and precision specifications, operational requirements, sample design, and estimations procedures. Details of the sample design are divided into two sections. The first section (NHANES 1999-2001 Sample Design) broadly describes the sample design and various design changes during the first three years of the continuous NHANES (1999-2001). The second section (NHANES 2002-2006 Sample Design) describes the final sample design developed and applied for 2002-2006. Weighting and variance estimation procedures are presented in the same manner; however, to correspond to the public data release cycles, the weighting and variance sections are separated into those used for 1999-2002, and those used for 2003-2006. Much of this report is based on survey operations documents and sample design reports prepared by Westat. Documentation of the survey content, procedures, and methods to assess nonsampling errors are reported elsewhere.
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Affiliation(s)
- Lester R Curtin
- U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782, USA
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Kruszon-Moran D, Porter KS, McQuillan G, Billioux VG, Kim-Farley R, Hirsch R. Infectious disease prevalence in Los Angeles county--a comparison to national estimates, 1999-2004 birth rates for U.S. teenagers reach historic lows for all age and ethnic groups. NCHS Data Brief 2012:1-8. [PMID: 22617137] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This is the first time seroprevalence of antibody to these nine infectious diseases have been available for LAC. Differences in the race and ethnicity distribution of the United States and LAC were observed. Because disease prevalence varies by race and ethnicity, in some instances these demographic differences affected the population differences seen between the United States and LAC in the seroprevalence of the infectious diseases reported in this study. Seroprevalence for HAV was higher in LAC as compared with the United States among the total population and among the Mexican-American population. California is 1 of 11 states in which routine vaccination of children was recommended in 1999 by the Advisory Committee on Immunization Practices (ACIP) because mean incidence rates in these states were at least twice the national mean from 1987–1997 (9). Seroprevalence to CMV and T. gondii have been shown to be higher among Mexican-American persons then other race and ethnicity groups (1,3). The higher seropositivity for CMV and T. gondii among persons from LAC is due to the higher proportion of Mexican-American persons in the LAC population. No differences in seropositivity were observed when comparing Mexican-American persons in the United States and LAC for these two outcomes. No significant differences in seroprevalence between the United States and LAC were seen for measles, mumps, rubella, varicella, HSV-1, and HSV-2. Estimates of seropositivity from immunization or disease for LAC may assist in policy development, program planning, and measuring health disparities.
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Affiliation(s)
- Deanna Kruszon-Moran
- Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road, Hyattsville, Maryland 20782, USA
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Abstract
Azithromycin is a macrolide antibiotic used extensively in medicine for the treatment of a wide range of infections such as upper respiratory tract infections, middle ear infections, sexually transmitted infections and trachoma. It is also effective against the most common periodontopathogens. The versatility of the macrolides extends beyond their antibiotic properties as a result of their well-documented immune-modulating/anti-inflammatory effects. Macrolides, including azithromycin, are therefore used to treat diseases not associated with bacteria, such as severe asthma, chronic obstructive pulmonary diseases and, more recently, cystic fibrosis. Azithromycin is concentrated in neutrophils, macrophages and particularly fibroblasts; all of these cells are central players in the pathogenesis of most periodontal diseases. This paper reviews the diverse properties of azithromycin and the clinical periodontal studies of its effects in both the treatment of periodontitis and in resolving drug-related gingival overgrowth. Evidence exists to support the use of a single course of azithromycin in the treatment of advanced periodontal diseases. Azithromycin could have a triple role in the treatment and resolution of periodontal diseases: suppressing periodontopathogens, anti-inflammatory activity and healing through persistence at low levels in macrophages and fibroblasts in periodontal tissues, even after a single course of three tablets. If future periodontal research confirms these properties, it could become a valuable host-modulator in periodontal treatment.
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Affiliation(s)
- R Hirsch
- School of Dentistry, The University of Adelaide, Adelaide, SA, Australia.
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27
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Sirken MG, Hirsch R, Mosher W, Moriarity C, Sonnenfeld N. Changing methods of NCHS surveys: 1960-2010 and beyond. MMWR Suppl 2011; 60:42-48. [PMID: 21976165] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- Monroe G Sirken
- Office of Director, National Center for Health Statistics, CDC, Hyattsville, Maryland, USA.
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Musacchio E, Ramonda R, Perissinotto E, Sartori L, Hirsch R, Punzi L, Zambon S, Corti MC, Baggio G, Manzato E, Doria A, Crepaldi G. The impact of knee and hip chondrocalcinosis on disability in older people: the ProVA Study from northeastern Italy. Ann Rheum Dis 2011; 70:1937-43. [PMID: 21821868 DOI: 10.1136/ard.2011.150508] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Chondrocalcinosis is frequently associated with osteoarthritis. The role of osteoarthritis in the onset and progression of disability is well known. The impact of chondrocalcinosis on disability has never been investigated in epidemiological studies. METHODS Progetto Veneto Anziani is a survey of 3099 older Italians, focusing on chronic diseases and disability. Assessment was by questionnaires, physical performance tests and clinical evaluations. Chondrocalcinosis was determined by x-ray readings of 1629 consecutive subjects. Knee and hip osteoarthritis severity was evaluated by summing the radiographic features score (RFS) assigned during x-ray reading. RESULTS SUBJECTS with chondrocalcinosis were older and more frequently women (age-adjusted p<0.0001). The gender association disappeared following adjustment for osteoarthritis severity. However, at the knee, the prevalence of osteoarthritis was higher in chondrocalcinosis patients independently of age and sex (age-adjusted p<0.0001). No difference was found between chondrocalcinosis and controls in sociodemographic variables and comorbidity. Knee chondrocalcinosis was strongly associated with clinical features of knee osteoarthritis and with disability assessment parameters in the bivariate analysis. Most associations remained after adjusting for age. After further adjustment for RFS, a significant association remained for knee deformity and pain, the need for a cane, difficulty walking 500 m, using a toilet, shopping and repeatedly rising from a chair. CONCLUSIONS Pain and physical function are the outcome measures of choice for assessing disability in osteoarthritis patients. The presence of chondrocalcinosis contributes to both, independently of age and osteoarthritis severity, thus compromising the quality of life and worsening comorbidity.
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Affiliation(s)
- Estella Musacchio
- Clinica Medica I, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy
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Baumgartner H, Bonhoeffer P, De Groot NMS, de Haan F, Deanfield JE, Galie N, Gatzoulis MA, Gohlke-Baerwolf C, Kaemmerer H, Kilner P, Meijboom F, Mulder BJM, Oechslin E, Oliver JM, Serraf A, Szatmari A, Thaulow E, Vouhe PR, Walma E, Bax J, Ceconi C, Dean V, Filippatos G, Funck-Brentano C, Hobbs R, Kearney P, McDonagh T, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Vardas P, Widimsky P, McDonagh T, Swan L, Andreotti F, Beghetti M, Borggrefe M, Bozio A, Brecker S, Budts W, Hess J, Hirsch R, Jondeau G, Kokkonen J, Kozelj M, Kucukoglu S, Laan M, Lionis C, Metreveli I, Moons P, Pieper PG, Pilossoff V, Popelova J, Price S, Roos-Hesselink J, Uva MS, Tornos P, Trindade PT, Ukkonen H, Walker H, Webb GD, Westby J. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010; 31:2915-57. [PMID: 20801927 DOI: 10.1093/eurheartj/ehq249] [Citation(s) in RCA: 1511] [Impact Index Per Article: 107.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Helmut Baumgartner
- Adult Congenital and Valvular Heart Disease Center (EMAH-Zentrum) Muenster, Department of Cardiology and Angiology, University Hospital Muenster, Albert-Schweitzer-Str. 33, D-48149 Muenster, Germany.
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Fryar CD, Hirsch R, Eberhardt MS, Yoon SS, Wright JD. Hypertension, high serum total cholesterol, and diabetes: racial and ethnic prevalence differences in U.S. adults, 1999-2006. NCHS Data Brief 2010:1-8. [PMID: 20423605] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Forty-five percent of adults had at least one of three diagnosed or undiagnosed chronic conditions—hypertension, hypercholesterolemia, or diabetes; one in eight adults (13%) had two of these conditions; and 3% of adults had all three chronic conditions. Nearly one in seven U.S. adults (15%) had one or more of these conditions undiagnosed. Non-Hispanic black persons were more likely than non-Hispanic white and Mexican-American persons to have at least one of the three conditions (diagnosed or undiagnosed). Non-Hispanic black and non-Hispanic white persons were more likely than Mexican-American persons to have both diagnosed or undiagnosed hypertension and hyper-cholesterolemia. Non-Hispanic black and Mexican-American persons were more likely than non-Hispanic white persons to have both diagnosed or undiagnosed hypertension and diabetes.
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Affiliation(s)
- Cheryl D Fryar
- Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road, Hyattsville, Maryland 20782, USA
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McQuillian GM, Kruszon-Moran D, Denniston MM, Hirsch R. Viral hepatitis. NCHS Data Brief 2010:1-8. [PMID: 20223109] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The prevalence of hepatitis A antibody, which is indicative of immunity to hepatitis A virus, increased among U.S. born persons aged 6-19, but decreased among persons aged 40 years and over. Hepatitis B virus (HBV) infection among persons aged 6-19 has decreased in recent years. By 2003-2006, over 90% of children had received at least one dose of the recommended three-dose series of hepatitis B vaccine. Prevalence of infection with hepatitis C virus (HCV) decreased among those at highest risk of infection including males and Mexican- American and non-Hispanic black populations. Despite this decrease, the prevalence of infection remains higher in the non-Hispanic black population. The peak prevalence of HCV infection has shifted over time from persons aged 30-39 years (3.9%) to those aged 40-49 years (4.3%).
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Affiliation(s)
- Geraldine M McQuillian
- Centers for Disease Control and Prevention National Center for Health Statistics 3311 Toledo Road, Hyattsville, Maryland 20782, USA
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Ramonda R, Musacchio E, Perissinotto E, Sartori L, Punzi L, Corti MC, Hirsch R, Manzato E, Zambon S, Baggio G, Crepaldi G. Prevalence of chondrocalcinosis in Italian subjects from northeastern Italy. The Pro.V.A. (PROgetto Veneto Anziani) study. Clin Exp Rheumatol 2009; 27:981-984. [PMID: 20149316] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To undertake an epidemiological survey of the prevalence of radiological chondrocalcinosis (CC) of the lower limbs in the elderly Italian population of the Pro.V.A. study. METHODS Knee and pelvic basin radiographs were performed on 3099 subjects aged 65 and older, residing in the Veneto Region of Italy (Rovigo and Camposampiero areas). Two readers independently analysed the knee, coxofemoral and pubic symphysis x-rays of a consecutive sample of 1629 subjects according to Altman. Some laboratory indexes, such as serum parathyroid hormone (PTH), vitamin D (vit D), bone alkaline phosphatase (bALP), deyidroepiandrosterone (DHEA), urinary CrossLaps (XL), and inflammatory biomarkers were evaluated. Quantitative variables were summarised as mean + or - standard deviation and qualitative ones as distributions. Unpaired t-test was used to compare mean values among groups for normally distributed variables, and non-parametric Mann-Whitney test for non normal variables. RESULTS CC was found in 169 (mean age 78.2 + or - 8.0 yrs) out of the 1629 subjects studied (10.4%). After adjusting for the sex and age structure of the target population, the prevalence was 10.0%. CC was more often observed in women than in men (M: 7.0%; F: 12.8%, p=0.0002), and increased in occurrence with age, rising from 7.8% in subjects aged 65-74 yrs, to 9.4% in those aged 75-84 yrs, and to 21.1% in subjects older than 85 yrs. The knee was the most prevalent location since it was affected in 94.1% of all the subjects with CC, in particular the right limb. Knee CC was bilateral in 71.7% of the affected patients. The occurrence of rheumatic disorders did not differ significantly between the subjects with CC and those without (rheumatoid arthritis 0.59% vs. 0.48%, p=ns). CONCLUSIONS Although the detection of CC was limited to few joints with the knee being the most affected location, our study confirms the frequent presence of CC at different sites, in keeping with the possible role of systemic factors. Articular CC is an age-related disorder, which could partly explain the prevalence discrepancies reported by various studies. The prevalence of CC found in our survey based on standardised x-ray reading was high, suggesting that CC could be an underdiagnosed disease in the absence of radiographic investigation.
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Affiliation(s)
- R Ramonda
- Cattedra e Divisione di Reumatologia, Dipartmento di Medicina Clinica e Sperimentale, Università di Padova, Italy.
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Fryar CD, Merino MC, Hirsch R, Porter KS. Smoking, alcohol use, and illicit drug use reported by adolescents aged 12-17 years: United States, 1999-2004. Natl Health Stat Report 2009:1-23. [PMID: 19634304] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE This report presents national prevalence estimates for self-reported health risk behaviors of smoking, alcohol use, and illicit drug use by U.S. adolescents aged 12-17 years in the National Health and Nutrition Examination Surveys (NHANES). METHODS Data in this report are from 6 years (1999-2004) of NHANES, which is conducted on a complex, stratified, multistage probability sample of the civilian, noninstitutionalized U.S. population. RESULTS The tables included in this report present weighted percentages and standard errors for smoking, alcohol, and illicit drug use behaviors in U.S. adolescents, by sex, race/ethnicity, education, and poverty level (when sufficient data are available). Selected highlights are presented from information included in the tables.
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Affiliation(s)
- Cheryl D Fryar
- US Department of Health And Human Services, Division of Health and Nutrition Examination Surveys, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782, USA
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Wright JD, Hirsch R, Wang CY. One-third of U.S adults embraced most heart healthy behaviors in 1999-2002. NCHS Data Brief 2009:1-8. [PMID: 19435550] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A number of U.S. Department of Health and Human Services programs recommend behaviors to reduce risk of cardiovascular disease (CVD), including the National High Blood Pressure Education Program (NHBPEP) and the National Cholesterol Education Program (NCEP) (1-6). The objective of this report is to estimate the prevalence of persons engaging in multiple behaviors recommended to reduce risk of CVD. Behaviors identified by NHBPEP and NCEP as primary lifestyle modifications to reduce CVD risk include physical activity, four dietary recommendations, smoking abstention, moderate alcohol consumption, and screening for high blood pressure and high blood cholesterol (5,6).
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Affiliation(s)
- Jacqueline D Wright
- Centers for Disease Control and Prevention's National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, USA
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Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Maradit Kremers H, Wolfe F. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008; 58:26-35. [PMID: 18163497 PMCID: PMC3266664 DOI: 10.1002/art.23176] [Citation(s) in RCA: 2840] [Impact Index Per Article: 177.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To provide a single source for the best available estimates of the US prevalence of and number of individuals affected by osteoarthritis, polymyalgia rheumatica and giant cell arteritis, gout, fibromyalgia, and carpal tunnel syndrome, as well as the symptoms of neck and back pain. A companion article (part I) addresses additional conditions. METHODS The National Arthritis Data Workgroup reviewed published analyses from available national surveys, such as the National Health and Nutrition Examination Survey and the National Health Interview Survey. Because data based on national population samples are unavailable for most specific rheumatic conditions, we derived estimates from published studies of smaller, defined populations. For specific conditions, the best available prevalence estimates were applied to the corresponding 2005 US population estimates from the Census Bureau, to estimate the number affected with each condition. RESULTS We estimated that among US adults, nearly 27 million have clinical osteoarthritis (up from the estimate of 21 million for 1995), 711,000 have polymyalgia rheumatica, 228,000 have giant cell arteritis, up to 3.0 million have had self-reported gout in the past year (up from the estimate of 2.1 million for 1995), 5.0 million have fibromyalgia, 4-10 million have carpal tunnel syndrome, 59 million have had low back pain in the past 3 months, and 30.1 million have had neck pain in the past 3 months. CONCLUSION Estimates for many specific rheumatic conditions rely on a few, small studies of uncertain generalizability to the US population. This report provides the best available prevalence estimates for the US, but for most specific conditions more studies generalizable to the US or addressing understudied populations are needed.
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Affiliation(s)
| | | | | | | | - Hyon Choi
- Massachusetts General Hospital, Boston
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Schober SE, Carroll MD, Lacher DA, Hirsch R. High serum total cholesterol--an indicator for monitoring cholesterol lowering efforts: U.S. adults, 2005-2006. NCHS Data Brief 2007:1-8. [PMID: 19389314] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Elevated serum total cholesterol is a major and modifiable risk factor for heart disease, the lead-ing cause of death in the United States (1,2). Reducing mean total serum cholesterol levels among adults to less than 200 mg/dL and reducing the proportion who have levels of 240 mg/dL or higher to less than 17% are national Healthy People 2010 objectives (3). Age-adjusted mean serum cholesterol levels among adults aged 20-74 years declined from 222 mg/dL in 1960-1962 to 203 mg/dL in 1999-2002 (4). Among adults aged 20 years and older, the percent of the population with high serum total cholesterol levels (240 mg/dL or higher) declined from 20% during 1988-1994 to 17% during 1999-2002 (4). In individual patients, a high serum total cholesterol level indicates a potential increased risk for heart disease, but further evaluation of other risk factors and the specific components of cholesterol provide the basis for determining the need for initiating therapeutic lifestyle changes or treatment with medication (5). Low-density-lipoprotein (LDL) is the cholesterol component associated with arterial blockage, and it is the primary clinical target for cholesterol management. High-density-lipoprotein (HDL) may help to protect individuals from developing heart disease. In populations, comparisons of total cholesterol levels over time can show if population groups are experiencing improvement in cholesterol levels, and knowledge of trends in levels of total cholesterol can help identify subgroups where additional prevention efforts may be needed.
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Affiliation(s)
- Susan E Schober
- Centers for Disease Control and Prevention, National Center for Health Statistics, 3311 Toledo Road, Hyattsville, Maryland 20782, USA
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Fryar CD, Hirsch R, Porter KS, Kottiri B, Brody DJ, Louis T. Drug use and sexual behaviors reported by adults: United States, 1999-2002. Adv Data 2007:1-14. [PMID: 17668724] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This report presents prevalence estimates for self-reported adult drug use and sexual behaviors in the United States. Data are from the National Health and Nutrition Examination Survey (NHANES) collected from 1999 to 2002. NHANES surveys a stratified multistage probability sample of the civilian noninstitutionalized population of the United States. Tables included in this report present estimates for use of cocaine, including crack or freebase, or other street drugs, and sexual behavior by selected sociodemographic characteristics among adults 20-59 years of age.
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Affiliation(s)
- Cheryl D Fryar
- Division of Health and Nutrition Examination Surveys, U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782, USA
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Shokoohi H, Shesser R, Hirsch R. Use of Cardiac Troponin I for Risk Stratification of Patients with Pulmonary Embolism in Emergency Department. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.1180] [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: 11/10/2022]
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Khan MA, Clegg DO, Deodhar AA, Gabriel S, Gaston JSH, Hirsch R, Ostergaard M, Reveille JD, Turkiewicz AM, Weisman MH, Davis JC. 2006 annual research and education meeting of the Spondyloarthritis Research and Therapy Network (SPARTAN). J Rheumatol 2007; 34:1118-24. [PMID: 17444582] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Muhammad Asim Khan
- Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio 44109-1998, USA.
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Abstract
OBJECTIVE To estimate the United States prevalence of symptomatic hand osteoarthritis using American College of Rheumatology (ACR) physical examination criteria. DESIGN The Third National Health and Nutrition Examination Survey (NHANES III), a nationally representative cross-sectional health examination survey, performed upper-extremity physical examinations on a sample of United States adults age 60+ yrs. Data for demographics, pain history, analgesic use, and activity limitations were obtained by interview. RESULTS Among United States adults, 58% had Heberden's nodes, 29.9% had Bouchard's nodes, and 18.2% had first carpal-metacarpal deformities. Women had significantly more first carpal-metacarpal deformities (24.3%) than men (10.3%). Symptomatic osteoarthritis prevalence at these sites was 5.4, 4.7, and 1.9%, respectively. Overall, symptomatic hand osteoarthritis prevalence by ACR criteria was 8% (95% CI 6.5-9.5%), or 2.9 million persons. Symptomatic hand osteoarthritis significantly increased with age and was decreased among non-Hispanic blacks, but there were no gender differences. Symptomatic hand osteoarthritis was associated with self-reported difficulty lifting 10 lbs (OR 2.31; 95% CI 1.23-4.33), dressing (OR 3.77; 95% CI 1.99-7.13), and eating (OR 3.44; 95% CI 1.76-6.73). Frequent monthly use was significantly increased for analgesics, especially acetaminophen, but not nonsteroidal antiinflammatory drugs. CONCLUSION Symptomatic hand osteoarthritis affects 1 in 12 older United States adults. NHANES III data provide a population-based assessment of the impact and associated functional impairments of symptomatic hand osteoarthritis.
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Affiliation(s)
- Charles F Dillon
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA
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Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, Liang MH, Kremers HM, Mayes MD, Merkel PA, Pillemer SR, Reveille JD, Stone JH. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I. ACTA ACUST UNITED AC 2007; 58:15-25. [PMID: 18163481 DOI: 10.1002/art.23177] [Citation(s) in RCA: 1533] [Impact Index Per Article: 90.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol 2006; 33:2271-9. [PMID: 17013996] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To estimate the US national prevalence of tibiofemoral radiographic knee osteoarthritis (RKOA) with and without symptoms, and its influence on functional tasks. METHODS Radiographic and interview data from the National Health and Nutrition Examination Survey (NHANES III), a nationally representative cross-sectional health examination survey, were used to estimate lifetime RKOA prevalence in adults age 60 years and older. Demographic trends, self-reported activity limitations, physical performance test results, and patterns of recent analgesic use were analyzed. RESULTS Among US adults, the prevalence of RKOA and symptomatic RKOA was 37.4% and 12.1%, respectively. RKOA prevalence was greater among women than men (42.1% vs 31.2%). Women had significantly more Kellgren-Lawrence Grade 3-4 changes (12.9% vs 6.5% in men). However, symptomatic RKOA prevalence did not differ by sex. Additionally, some 1.6% of US adults had knee joint replacement. Multivariable analysis showed significantly higher odds of both RKOA and symptomatic RKOA with greater body mass index (BMI > or = 30), greater age, non-Hispanic Black race/ethnicity, and among men with manual labor occupations. Only symptomatic RKOA was significantly associated with self-reported activity limitations: difficulty walking, stooping, standing from a seated position, and stair climbing. Adults with symptomatic RKOA used significantly more assistive walking devices, had slower measured gait velocities, and used significantly more prescription nonsteroidal antiinflammatory drugs and prescription narcotics, and nonprescription acetaminophen. CONCLUSION NHANES III data provide an overall national assessment of the prevalence, demographic distributions, and functional impact of symptomatic knee OA, which affects more than 1 in 10, or 4.3 million older US adults.
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Affiliation(s)
- Charles F Dillon
- Division of Health and Nutrition Examination Statistics, National Center for Health Statistics, DHANES, 3311 Toledo Road, Hyattsville, MD 20782, USA.
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Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol 2006. [PMID: 17013996 DOI: jrheum.org/content/33/11/2271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To estimate the US national prevalence of tibiofemoral radiographic knee osteoarthritis (RKOA) with and without symptoms, and its influence on functional tasks. METHODS Radiographic and interview data from the National Health and Nutrition Examination Survey (NHANES III), a nationally representative cross-sectional health examination survey, were used to estimate lifetime RKOA prevalence in adults age 60 years and older. Demographic trends, self-reported activity limitations, physical performance test results, and patterns of recent analgesic use were analyzed. RESULTS Among US adults, the prevalence of RKOA and symptomatic RKOA was 37.4% and 12.1%, respectively. RKOA prevalence was greater among women than men (42.1% vs 31.2%). Women had significantly more Kellgren-Lawrence Grade 3-4 changes (12.9% vs 6.5% in men). However, symptomatic RKOA prevalence did not differ by sex. Additionally, some 1.6% of US adults had knee joint replacement. Multivariable analysis showed significantly higher odds of both RKOA and symptomatic RKOA with greater body mass index (BMI > or = 30), greater age, non-Hispanic Black race/ethnicity, and among men with manual labor occupations. Only symptomatic RKOA was significantly associated with self-reported activity limitations: difficulty walking, stooping, standing from a seated position, and stair climbing. Adults with symptomatic RKOA used significantly more assistive walking devices, had slower measured gait velocities, and used significantly more prescription nonsteroidal antiinflammatory drugs and prescription narcotics, and nonprescription acetaminophen. CONCLUSION NHANES III data provide an overall national assessment of the prevalence, demographic distributions, and functional impact of symptomatic knee OA, which affects more than 1 in 10, or 4.3 million older US adults.
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Affiliation(s)
- Charles F Dillon
- Division of Health and Nutrition Examination Statistics, National Center for Health Statistics, DHANES, 3311 Toledo Road, Hyattsville, MD 20782, USA.
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Abstract
Cannabis, commonly known as marijuana, is the most frequently used illicit drug in Australia. Therefore, oral health care providers are likely to encounter patients who are regular users. An upward trend in cannabis use is occurring in Australia, with 40 per cent of the population aged 14 and above having used the drug. There are three main forms of cannabis: marijuana, hash and hash oil, all of which contain the main psychoactive constituent delta-9-tetrahydrocannabinol (THC). Cannabis is most commonly smoked, however it can be added to foods. THC from cannabis enters the bloodstream and exerts its effects on the body via interaction with endogenous receptors. Cannabis affects almost every system of the body, particularly the cardiovascular, respiratory and immune systems. It also has acute and chronic effects on the mental health of some users. Therefore, chronic abuse is a concern because of its negative effects on general physical and mental health. Cannabis abusers generally have poorer oral health than non-users, with an increased risk of dental caries and periodontal diseases. Cannabis smoke acts as a carcinogen and is associated with dysplastic changes and pre-malignant lesions within the oral mucosa. Users are also prone to oral infections, possibly due to the immunosuppressive effects. Dental treatment on patients intoxicated on cannabis can result in the patient experiencing acute anxiety, dysphoria and psychotic-like paranoiac thoughts. The use of local anaesthetic containing epinephrine may seriously prolong tachycardia already induced by an acute dose of cannabis. Oral health care providers should be aware of the diverse adverse effects of cannabis on general and oral health and incorporate questions about patients' patterns of use in the medical history.
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Affiliation(s)
- C M Cho
- Dental School, The University of Adelaide, South Australia.
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Paulose-Ram R, Hirsch R, Dillon C, Gu Q. Frequent monthly use of selected non-prescription and prescription non-narcotic analgesics among U.S. adults. Pharmacoepidemiol Drug Saf 2005; 14:257-66. [PMID: 15386703 DOI: 10.1002/pds.983] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
PURPOSE Analgesics offer many benefits, however, chronic, long-term use may pose risks of adverse drug events. The objective of this study was to estimate frequent monthly non-narcotic analgesic use among U.S. adults, identifying socio-demographic trends and potentially at-risk groups. METHODS Analysis of adult medication use data from the 1999-2000 National Health and Nutrition Examination Survey household interview (n = 4880). RESULTS Some 20% of U.S. adults used non-prescription or prescription non-narcotic analgesics on a frequent basis, that is nearly every day for a month, at some point during their lifetime. Also, 14% of U.S. adults were currently using analgesics frequently. Aspirin was most commonly used (8%), followed by non-aspirin non-steroidal anti-inflammatory drugs (NANSAID, 3%) and acetaminophen (3%). Three-quarters of aspirin, 46% of NANSAID and 63% of acetaminophen users were long-term frequent monthly users (1+ years). Seven percent of frequent monthly analgesic users reported using two or more analgesics nearly every day during the month. Frequent analgesic use was most common among older adults and non-Hispanic whites with no differences by gender or education. Use patterns, however, varied by analgesic subgroups. CONCLUSIONS Frequent monthly non-narcotic analgesic use, especially of over-the-counter analgesics, is widely prevalent among U.S. adults. Health-care providers should heighten their awareness of this trend, and routinely monitor both non-prescription and prescription analgesic use in their patients to prevent adverse drug effects and inappropriate use.
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Affiliation(s)
- Ryne Paulose-Ram
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
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McDowell MA, Fryar CD, Hirsch R, Ogden CL. Anthropometric reference data for children and adults: U.S. population, 1999-2002. Adv Data 2005:1-5. [PMID: 16018338] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This report presents national anthropometric reference data based on health examination survey results from the National Health and Nutrition Examination Survey (NHANES), 1999-2002, for all ages of the U.S. population. Weighted population means, standard errors of the means, and selected percentiles are presented for the total U.S. population by sex, race or ethnic group, and age in years or age group. Findings for some population groups are reported in a way that is comparable with results reported from National Health Examination Surveys (NHES) and NHANES conducted between 1960 and 1994. These data add to the knowledge about trends in child growth and development and are used to monitor prevalent conditions in the U.S. population such as overweight and obesity.
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Affiliation(s)
- Margaret A McDowell
- Division of Health and Nutrition Examination Surveys, U.S. DEpartment of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland 20782, USA
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Hermann LM, Pinkerton M, Jennings K, Yang L, Grom A, Sowders D, Kersten S, Witte DP, Hirsch R, Thornton S. Angiopoietin-like-4 is a potential angiogenic mediator in arthritis. Clin Immunol 2005; 115:93-101. [PMID: 15870027 DOI: 10.1016/j.clim.2004.12.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2004] [Accepted: 12/07/2004] [Indexed: 10/25/2022]
Abstract
Our previous studies of gene expression profiling during collagen-induced arthritis (CIA) indicated that the putative angiogenic factor Angptl4 was one of the most highly expressed mRNAs early in disease. To investigate the potential involvement of Angptl4 in CIA pathogenesis, Angptl4 protein levels were assessed at early stages of disease and its cellular sources were determined. In addition, the functional effects of mouse Angptl4 on endothelial cells were assessed. Angptl4 protein levels were higher in arthritic joints as compared to normal joints. In situ hybridization localized Angptl4 mRNA to stromal fibroblast-like cells within the inflamed synovium. Temporal expression of Angptl4 mRNA during CIA was similar to that of key angiogenic factors, including structurally related angiopoietin 1. Recombinant mouse Angptl4 promoted endothelial cell survival and formation of tubule-like structures. These functional effects of Angptl4, combined with very high expression at early stages of CIA, suggest a role for Angptl4 in angiogenesis in arthritis.
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MESH Headings
- Angiopoietin-1/immunology
- Angiopoietin-Like Protein 4
- Angiopoietins
- Animals
- Arthritis, Experimental/immunology
- Arthritis, Experimental/pathology
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/pathology
- Blood Proteins/biosynthesis
- Blood Proteins/genetics
- Blood Proteins/immunology
- Blotting, Western
- Collagen
- Endothelial Cells
- Humans
- In Situ Hybridization
- Interleukin-1 Receptor-Like 1 Protein
- Male
- Membrane Proteins/immunology
- Mice
- Mice, Inbred DBA
- Neovascularization, Pathologic/immunology
- Oligonucleotide Array Sequence Analysis
- Platelet Endothelial Cell Adhesion Molecule-1/immunology
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- Receptor, TIE-2/immunology
- Receptors, Interleukin
- Vascular Endothelial Growth Factor A
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Affiliation(s)
- L M Hermann
- William S. Rowe Division of Rheumatology, Cincinnati Children's Hospital, 3333 Burnet Avenue, ML 4010, Cincinnati, OH 45229, USA
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Abstract
BACKGROUND [corrected] This clinical study assessed the effects of topically applied tea tree oil (TTO)-containing gel on dental plaque and chronic gingivitis. METHODS This was a double-blind, longitudinal, non-crossover study in 49 medically fit non-smokers (24 males and 25 females) aged 18-60 years with severe chronic gingivitis. Subjects were randomly assigned to three groups and given either TTO-gel (2.5 per cent), chlorhexidine (CHX) gel (0.2 per cent), or a placebo gel to apply with a toothbrush twice daily. Treatment effects were assessed using the Gingival Index (GI), Papillary Bleeding Index (PBI) and plaque staining score (PSS) at four and eight weeks. RESULTS No adverse reactions to any of the gels were reported. The data were separated into subsets by tooth (anterior and posterior) and tooth surface (buccal and lingual). The TTO group had significant reduction in PBI and GI scores. However,,TTO did not reduce plaque scores, which tended to increase over the latter weeks of the study period. CONCLUSION Although further studies are required, the anti-inflammatory properties of TTO-containing gel applied topically to inflamed gingival tissues may prove to be a useful non-toxic adjunct to chemotherapeutic periodontal therapy.
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Affiliation(s)
- S Soukoulis
- Dental School, The University of Adelaide, South Australia
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