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Iyer K, Kumar M, Kannan R, Narayanan A, Moothedath M, Khanagar SB, Bijai LK. Clinical and histopathological correlation of oral malignancy and potentially malignant disorders based on a screening program at high-risk population in Tamil Nadu, India. Front Oral Health 2023; 4:1286780. [PMID: 38024143 PMCID: PMC10655261 DOI: 10.3389/froh.2023.1286780] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background There is a high incidence of oral cancer and oral potential malignant disorder observed in southeast Asian countries such as India. Our study aimed to assess the correlation between screening and histopathological diagnosis and to predict the specificity and sensitivity of chair-side/field-based assessment of the oral lesion. Materials and methods A total of 40,852 subjects aged between 20 and 60 years were screened in the 1st phase of the study, suspected lesions were stained with toluidine blue (Manufactured by Otto Chemicals private limited, India) at two time points, those who stained positively during the two points were taken up for biopsy. Provisional diagnosis was later correlated with histopathological diagnosis. Results Subjects who underwent biopsy had a mean age of (49.01 ± 9.8 years), Leukoplakia (1.5%) was the most common lesion observed among tobacco users, interestingly it had the least correlation (39.6%) in diagnosis, Overall sensitivity (88%) and a positive predictive value (80%) was high for clinical diagnosis of OPMD in our study. Conclusion Correlation of clinical and histopathological diagnosis observed in our study confirms higher yield of true positives while screening in remote and vulnerable populations, which would assure a better quality of life for these subjects.
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Affiliation(s)
- Kiran Iyer
- Dental Public Health, Preventive Dental Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Madan Kumar
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, India
| | - Ranganathan Kannan
- Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, India
| | | | - Muhamood Moothedath
- Department of Oral and Dental Health Sciences in Ar Rass, Qassim University, Al Qassim, Saudi Arabia
| | - Sanjeev Balappa Khanagar
- Dental Public Health, Preventive Dental Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Laliytha Kumar Bijai
- Oral Medicine and Maxillofacial Radiology, Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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2
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Schwaiger JP, Kollerits B, Steinbrenner I, Weissensteiner H, Schönherr S, Forer L, Kotsis F, Lamina C, Schneider MP, Schultheiss UT, Wanner C, Köttgen A, Eckardt KU, Kronenberg F. Apolipoprotein A-IV concentrations and clinical outcomes in a large chronic kidney disease cohort: Results from the GCKD study. J Intern Med 2022; 291:622-636. [PMID: 34914850 PMCID: PMC9305919 DOI: 10.1111/joim.13437] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) represents a chronic proinflammatory state and is associated with very high cardiovascular risk. Apolipoprotein A-IV (apoA-IV) has antiatherogenic, antioxidative, anti-inflammatory and antithrombotic properties and levels increase significantly during the course of CKD. OBJECTIVES We aimed to investigate the association between apoA-IV and all-cause mortality and cardiovascular outcomes in the German Chronic Kidney Disease study. METHODS This was a prospective cohort study including 5141 Caucasian patients with available apoA-IV measurements and CKD. The majority of the patients had an estimated glomerular filtration rate (eGFR) of 30-60 ml/min/1.73m2 or an eGFR >60 ml/min/1.73m2 in the presence of overt proteinuria. Median follow-up was 6.5 years. The association of apoA-IV with comorbidities at baseline and endpoints during follow-up was modelled adjusting for major confounders. RESULTS Mean apoA-IV concentrations of the entire cohort were 28.9 ± 9.8 mg/dl. Patients in the highest apoA-IV quartile had the lowest high-sensitivity C-reactive protein values despite the highest prevalence of diabetes, albuminuria and the lowest eGFR. Each 10 mg/dl higher apoA-IV translated into lower odds of prevalent cardiovascular disease (1289 cases, odds ratio = 0.80, 95% confidence interval [CI] 0.72-0.86, p = 0.0000003). During follow-up, each 10 mg/dl higher apoA-IV was significantly associated with a lower risk for all-cause mortality (600 cases, hazard ratio [HR] = 0.81, 95% CI 0.73-0.89, p = 0.00004), incident major adverse cardiovascular events (506 cases, HR = 0.88, 95% CI 0.79-0.99, p = 0.03) and death or hospitalizations due to heart failure (346 cases, HR = 0.84, 95% CI 0.73-0.96, p = 0.01). CONCLUSIONS These data support a link between elevated apoA-IV concentrations and reduced inflammation in moderate CKD. ApoA-IV appears to be an independent risk marker for reduced all-cause mortality, cardiovascular events and heart failure in a large cohort of patients with CKD.
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Affiliation(s)
- Johannes P Schwaiger
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria.,Department of Internal Medicine, Landeskrankenhaus Hall i.T., Hall in Tirol, Austria
| | - Barbara Kollerits
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Inga Steinbrenner
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Hansi Weissensteiner
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sebastian Schönherr
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lukas Forer
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Fruzsina Kotsis
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Department of Medicine IV - Nephrology and Primary Care, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Claudia Lamina
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Markus P Schneider
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ulla T Schultheiss
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.,Department of Medicine IV - Nephrology and Primary Care, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Christoph Wanner
- Division of Nephrology, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Anna Köttgen
- Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Kronenberg
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
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- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
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3
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Snyder BM, Patterson MF, Gebretsadik T, Cacho F, Ding T, Turi KN, Abreo A, Wu P, Hartert TV. Association between asthma status and prenatal antibiotic prescription fills among women in a Medicaid population. J Asthma 2021; 59:2100-2107. [PMID: 34663171 DOI: 10.1080/02770903.2021.1993247] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Pregnant women with asthma have increased frequency of respiratory viral infections and exacerbations. Because of these risks, women with asthma may be subject to increased surveillance during pregnancy and may, therefore, be at increased risk of antibiotic receipt. The objective of this study was to assess the relationship between maternal asthma and outpatient prenatal antibiotic prescription fills to inform antibiotic stewardship. METHODS We included women who delivered a singleton, term, non-low birthweight, and otherwise healthy infant enrolled in the Tennessee Medicaid Program. Maternal asthma and prenatal antibiotic fills were ascertained from healthcare encounters and outpatient pharmacy claims. We examined the association between maternal asthma and prenatal antibiotic fills using modified Poisson regression. RESULTS Our study population included 168354 pregnant women, 4% of whom had asthma. Women with asthma had an increased risk of filling at least one prenatal antibiotic prescription (adjusted risk ratio [aRR] 1.27, 95% confidence interval [CI] 1.25-1.28) and had an increased number of fills during pregnancy (aRR 1.54, 95% CI 1.51-1.57) compared to women without asthma. Among those who filled at least one antibiotic prescription, women with asthma had earlier first prenatal antibiotic prescription fill and increased likelihood of filling at least one course of broad-spectrum antibiotics during pregnancy (versus narrow-spectrum). CONCLUSIONS Pregnant women with asthma had more outpatient antibiotic prescription fills than pregnant women without asthma. These findings highlight that pregnant women with asthma disproportionately fill more antibiotic prescriptions during pregnancy, providing data that may inform antibiotic stewardship.
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Affiliation(s)
- Brittney M Snyder
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Megan F Patterson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tebeb Gebretsadik
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ferdinand Cacho
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tan Ding
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kedir N Turi
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew Abreo
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Pingsheng Wu
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tina V Hartert
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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4
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Barbhaya D, Franco S, Gandhi K, Arya R, Neupane R, Foroughi N, Oluigbo N, Fishbein D, Tran J. Characteristics and Outcomes of COVID-19 Infection from an Urban Ambulatory COVID-19 Clinic-Guidance for Outpatient Clinicians in Triaging Patients. J Prim Care Community Health 2021; 12:21501327211017016. [PMID: 33985374 PMCID: PMC8127736 DOI: 10.1177/21501327211017016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Coronavirus infection (COVID) presents with flu-like symptoms and can cause serious complications. Here, we discuss the presentation and outcomes of COVID in an ambulatory setting along with distribution of positive cases amongst healthcare workers (HCWs). METHOD Patients who visited the COVID clinic between 03/11/2020 and 06/14/2020 were tested based on the CDC guidelines at the time using PCR-detection methods. Medical records were reviewed and captured on a RedCap database. Statistical analysis was performed using both univariate and bivariate analysis using Fischer's exact test with 2-sided P values. RESULTS Of the 2471 evaluated patients, 846 (34.2%) tested positive for COVID. Mean age of positivity was 43.4 years (SD ± 15.4), 60.1% were female and 49% were Black. 58.7% of people tested had a known exposure, and amongst those with exposure, 57.3% tested positive. Ninety-four patients were hospitalized (11.1%), of which 22 patients (23.4%) required ICU admission and 10 patients died. The overall death rate of patients presenting to clinic was 0.4%, or 1.2% amongst positive patients. Median length of hospital stay was 6 days (range 1-51). Symptoms significantly associated with COVID included: anosmia, fever, change in taste, anorexia, myalgias, cough, chills, and fatigue. Increased risk of COVID occurred with diabetes, whereas individuals with lung disease or malignancy were not associated with increased risk of COVID. Amongst COVID positive HCWs, the majority were registered nurses (23.4%), most working in general medicine (39.8%) followed by critical care units (14.3%). DISCUSSION/CONCLUSION Blacks and females had the highest infection rates. There was a broad range in presentation from those who are very ill and require hospitalization and those who remain ambulatory. The above data could assist health care professionals perform a targeted review of systems and co-morbidities, allowing for appropriate patient triage.
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Affiliation(s)
| | | | - Kejal Gandhi
- Medstar Washington Hospital Center, Washington, DC, USA
| | - Radhika Arya
- Medstar Washington Hospital Center, Washington, DC, USA
| | - Rabin Neupane
- Medstar Washington Hospital Center, Washington, DC, USA
| | | | | | - Dawn Fishbein
- Medstar Washington Hospital Center, Washington, DC, USA.,MedStar Health Research Institute, Washington, DC, USA
| | - Jennifer Tran
- Medstar Washington Hospital Center, Washington, DC, USA
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Abstract
Combining spatial and temporal data is helping researchers to understand how deforestation influences the risk of malaria.
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Affiliation(s)
- Mercedes Pascual
- Department of Ecology and Evolution, University of Chicago, Chicago, United States
| | - Andres Baeza
- Department of Ecology and Evolution, University of Chicago, Chicago, United States.,Global Drylands Center, Arizona State University, Chicago, United States
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6
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Rerolle F, Dantzer E, Lover AA, Marshall JM, Hongvanthong B, Sturrock HJ, Bennett A. Spatio-temporal associations between deforestation and malaria incidence in Lao PDR. eLife 2021; 10:56974. [PMID: 33686939 PMCID: PMC8024023 DOI: 10.7554/elife.56974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/16/2020] [Accepted: 02/19/2021] [Indexed: 11/13/2022] Open
Abstract
As countries in the Greater Mekong Sub-region (GMS) increasingly focus their malaria control and elimination efforts on reducing forest-related transmission, greater understanding of the relationship between deforestation and malaria incidence will be essential for programs to assess and meet their 2030 elimination goals. Leveraging village-level health facility surveillance data and forest cover data in a spatio-temporal modeling framework, we found evidence that deforestation is associated with short-term increases, but long-term decreases confirmed malaria case incidence in Lao People’s Democratic Republic (Lao PDR). We identified strong associations with deforestation measured within 30 km of villages but not with deforestation in the near (10 km) and immediate (1 km) vicinity. Results appear driven by deforestation in densely forested areas and were more pronounced for infections with Plasmodium falciparum (P. falciparum) than for Plasmodium vivax (P. vivax). These findings highlight the influence of forest activities on malaria transmission in the GMS. Biting mosquitos spread the malaria parasite to humans. Along the Mekong River in Southeast Asia, spending time in the surrounding forest increases a person's risk of malaria. This has led to a debate about whether deforestation in this area, which is called the Greater Mekong Sub-region (GMS), will increase or decrease malaria transmission. The answer to the debate is not clear because some malaria-transmitting mosquitos thrive in heavily forested areas, in particular in the GMS, while others prefer less forested areas. Scientists studying malaria in the Amazon in South America suspect that malaria transmission increases shortly after deforestation but decreases six to eight years later. Some studies have tested this ‘frontier malaria’ theory but the results have been conflicting. Fewer studies have tested this theory in Southeast Asia. But deforestation has been blamed for recent malaria outbreaks in the GMS. Using data on malaria testing and forest cover in the GMS, Rerolle et al. show that deforestation around villages increases malaria transmission in the first two years and decreases malaria rates later. This trend was driven mostly by a type of malaria called Plasmodium falciparum and was less strong for Plasmodium vivax. The location of deforested areas also mattered. Deforestation within one to 10 kilometer of villages did not affect malaria rates. Deforestation further away in about a 30 kilometer radius did affect malaria transmission. Rerolle et al. suggest this may be because villagers have to spend longer times trekking through forests to hunt or harvest wood when the wider area is deforested. Currently, National Malaria Control Programs in the GMS focus their efforts on reducing forest-related transmission. This study strengthens the evidence supporting this approach. The results also suggest that different malaria elimination strategies may be necessary for different types of malaria parasite. Using this new information could help malaria control programs better target resources or educate villagers on how to protect themselves. The innovative methods used by Rerolle et al. reveal a more complex role of deforestation in malaria transmission and may inspire other scientists to think more carefully about environmental drivers of malaria.
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Affiliation(s)
- Francois Rerolle
- Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, San Francisco, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, United States
| | - Emily Dantzer
- Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, San Francisco, United States
| | - Andrew A Lover
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, United States
| | - John M Marshall
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, United States
| | - Bouasy Hongvanthong
- Center for Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Hugh Jw Sturrock
- Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, San Francisco, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, United States
| | - Adam Bennett
- Malaria Elimination Initiative, The Global Health Group, University of California, San Francisco, San Francisco, United States.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, United States
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7
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Piepoli MF, Corrà U, Adamopoulos S, Benzer W, Bjarnason-Wehrens B, Cupples M, Dendale P, Doherty P, Gaita D, Höfer S, McGee H, Mendes M, Niebauer J, Pogosova N, Garcia-Porrero E, Rauch B, Schmid JP, Giannuzzi P. Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery. Eur J Prev Cardiol 2012; 21:664-81. [DOI: 10.1177/2047487312449597] [Citation(s) in RCA: 395] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Massimo F Piepoli
- Cardiology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Ugo Corrà
- Department of Cardiology, Fondazione Salvatore Maugeri, IRCCS Scientific Institute of Veruno, Veruno, Italy
| | | | - Werner Benzer
- Department of Interventional Cardiology, Academic Hospital, Feldkirch, Austria
| | | | - Margaret Cupples
- Department of General Practice, Centre of Excellence for Public Health, Queen’s University, Belfast, UK
| | - Paul Dendale
- Jessa Hospital and University of Hasselt, Hasselt, Belgium
| | | | - Dan Gaita
- 0Departamentul de Cardiologie, Universitatea de Medicina si Farmacie ‘Victor Babes’ din Timisoara, Romania
| | - Stefan Höfer
- 1Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria
| | - Hannah McGee
- 2Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Miguel Mendes
- 3Cardiology Department, CHLO-Hospital de Santa Cruz, Carnaxide, Portugal
| | - Josef Niebauer
- 4Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Nana Pogosova
- 5National Research Centre for Preventive Medicine, Moscow, Russian Federation
| | | | - Bernhard Rauch
- 7ZAR – Centre for Ambulatory Cardiovascular Rehabilitation at the Heart Centre Ludwigshafen, Germany
| | - Jean Paul Schmid
- 8Cardiovascular Prevention and Rehabilitation, Department of Cardiology, Bern University Hospital, and University of Bern, Switzerland
| | - Pantaleo Giannuzzi
- Department of Cardiology, Fondazione Salvatore Maugeri, IRCCS Scientific Institute of Veruno, Veruno, Italy
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