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  • 1
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    Salvage surgery for recurrent squamous cell carcinoma of the head and neck: Systematic review and meta‐analysis
    Wiley ; 2022
    In:  Head & Neck Vol. 44, No. 1 ( 2022-01), p. 275-285
    Details
    In: Head & Neck, Wiley, Vol. 44, No. 1 ( 2022-01), p. 275-285
    Abstract: The present study aims to estimate a pooled hazard ratio (HR) comparing overall survival (OS) for salvage surgery compared to nonsurgical management of recurrent head and neck squamous cell carcinoma (HNSCC). PubMed/MEDLINE and Embase‐Ovid were searched on March 5, 2020, for English‐language articles reporting survival for salvage surgery and nonsurgical management of recurrent HNSCC. Meta‐analysis of HR estimates using random effects model was performed. Fifteen studies reported survival for salvage surgery and nonsurgical management of recurrence. Five‐year OS ranged from 26% to 67% for the salvage surgery groups, compared to 0% to 32% for the nonsurgical management groups. Six studies reported HRs comparing salvage surgery to nonsurgical management; the pooled HR was 0.25 (95% CI [0.16, 0.38]; p   〈  0.0001). Selection for salvage surgery was associated with one quarter of the mortality rate associated with nonsurgical management in light of confounding factors including subsite and treatment intent.
    Type of Medium: Online Resource
    ISSN: 1043-3074 , 1097-0347
    URL: Issue
    URL: Article
    DOI: 10.1002/hed.v44.1
    DOI: 10.1002/hed.26898
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2001440-5
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  • 2
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    PREVALENCE OF CARDIAC INVOLVEMENT IN HOSPITALIZED PATIENTS WITH COVID-19: ECHOCARDIOGRAPHIC FINDINGS IN A REGISTRY OF 768 PATIENTS
    Elsevier BV ; 2021
    In:  Journal of the American College of Cardiology Vol. 77, No. 18 ( 2021-05), p. 3181-
    Details
    In: Journal of the American College of Cardiology, Elsevier BV, Vol. 77, No. 18 ( 2021-05), p. 3181-
    Type of Medium: Online Resource
    ISSN: 0735-1097
    URL: Article
    DOI: 10.1016/S0735-1097(21)04536-8
    RVK:
    XA 17760
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 1468327-1
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  • 3
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    Cardiac involvement in hospitalized patients with COVID-19 and its incremental value in outcomes prediction
    Springer Science and Business Media LLC ; 2021
    In:  Scientific Reports Vol. 11, No. 1 ( 2021-09-30)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-09-30)
    Abstract: Recent reports linked acute COVID-19 infection in hospitalized patients to cardiac abnormalities. Studies have not evaluated presence of abnormal cardiac structure and function before scanning in setting of COVD-19 infection. We sought to examine cardiac abnormalities in consecutive group of patients with acute COVID-19 infection according to the presence or absence of cardiac disease based on review of health records and cardiovascular imaging studies. We looked at independent contribution of imaging findings to clinical outcomes. After excluding patients with previous left ventricular (LV) systolic dysfunction (global and/or segmental), 724 patients were included. Machine learning identified predictors of in-hospital mortality and in-hospital mortality + ECMO. In patients without previous cardiovascular disease, LV EF  〈  50% occurred in 3.4%, abnormal LV global longitudinal strain ( 〈  16%) in 24%, and diastolic dysfunction in 20%. Right ventricular systolic dysfunction (RV free wall strain  〈  20%) was noted in 18%. Moderate and large pericardial effusion were uncommon with an incidence of 0.4% for each category. Forty patients received ECMO support, and 79 died (10.9%). A stepwise increase in AUC was observed with addition of vital signs and laboratory measurements to baseline clinical characteristics, and a further significant increase (AUC 0.91) was observed when echocardiographic measurements were added. The performance of an optimized prediction model was similar to the model including baseline characteristics + vital signs and laboratory results + echocardiographic measurements.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-021-98773-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2615211-3
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  • 4
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    Abstract 10623: Association of Changes in Glycemic Status and Risk of Cardiovascular Disease Among Adults With Hypertension - A Post-Hoc Analysis of the Systolic Blood Pressure Intervention Trial (SPRINT)
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: Prediabetes (preDM) is a risk factor for diabetes mellitus (DM) and both are associated with elevated risk of cardiovascular disease (CVD). However, the association of transitions in glycemic status with cardiovascular disease (CVD) is not well established. Methods: The present study included participants with hypertension enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT) without DM at baseline. Study participants had available fasting plasma glucose (FPG) at baseline and 2-year follow-up and no primary outcome CVD event (myocardial infarction, other acute coronary syndrome, stroke, heart failure, or cardiovascular death) prior to 2 years. Euglycemia, preDM, and DM status were defined based on FPG, self-reported history, or use of glucose-lowering medication. Participants were stratified by glycemic status at baseline and 2-year follow up. The association of changes in glycemic status with CVD risk were assessed using adjusted Cox models. Results: The present study included 4,708 participants (33.6% women, 35.1% Black, 41.4% preDM). Among 2,760 participants with euglycemia at baseline, 716 (25.9%) developed preDM or DM over 2-year follow-up. Most participants with baseline preDM continued to have preDM or progressed to DM (71.3%). After the 2-year visit, 151 participants (3.2%) had a CVD event. Participants with persistent euglycemia had fewer CVD events (2.6%) compared with those with incident preDM or DM on follow-up (4.5%) (Figure 1A). In adjusted analysis, among participants with baseline euglycemia, those who developed prediabetes or diabetes had 70% higher risk of a CVD event during follow-up compared with those with persistent euglycemia (HR [95% CI], 1.70 [1.09-2.64] ) (Figure 1B). Conclusions: In adults with hypertension, worsening glycemic status from euglycemia to preDM or DM was associated with higher risk for CVD. Prevention of dysglycemia may be an important target to prevent CVD in hypertension.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.10623
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 5
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    A multi-country cross-sectional study of self-reported sexually transmitted infections among sexually active men in sub-Saharan Africa
    Springer Science and Business Media LLC ; 2020
    In:  BMC Public Health Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Despite the importance of self-reporting health in sexually transmitted infections (STIs) control, studies on self-reported sexually transmitted infections (SR-STIs) are scanty, especially in sub-Saharan Africa (SSA). This study assessed the prevalence and factors associated with SR-STIs among sexually active men (SAM) in SSA. Methods Analysis was done based on the current Demographic and Health Survey of 27 countries in SSA conducted between 2010 and 2018. A total of 130,916 SAM were included in the analysis. The outcome variable was SR-STI. Descriptive and inferential statistics were performed with a statistical significance set at p   〈  0.05. Results On the average, the prevalence of STIs among SAM in SSA was 3.8%, which ranged from 13.5% in Liberia to 0.4% in Niger. Sexually-active men aged 25–34 (AOR = 1.77, CI:1.6–1.95) were more likely to report STIs, compared to those aged 45 or more years. Respondents who were working (AOR = 1.24, CI: 1.12–1.38) and those who had their first sex at ages below 20 (AOR = 1.20, CI:1.11–1.29) were more likely to report STIs, compared to those who were not working and those who had their first sex when they were 20 years and above. Also, SAM who were not using condom had higher odds of STIs (AOR = 1.35, CI: 1.25–1.46), compared to those who were using condom. Further, SAM with no comprehensive HIV and AIDS knowledge had higher odds (AOR = 1.43, CI: 1.08–1.22) of STIs, compared to those who reported to have HIV/AIDS knowledge. Conversely, the odds of reporting STIs was lower among residents of rural areas (AOR = 0.93, CI: 0.88–0.99) compared to their counterparts in urban areas, respondents who had no other sexual partner (AOR = 0.32, CI: 0.29–0.35) compared to those who had 2 or more sexual partners excluding their spouses, those who reported not paying for sex (AOR = 0.55, CI: 0.51–0.59) compared to those who paid for sex, and those who did not read newspapers (AOR = 0.93, CI: 0.86–0.99) compared to those who read. Conclusion STIs prevalence across the selected countries in SSA showed distinct cross-country variations. Current findings suggest that STIs intervention priorities must be given across countries with high prevalence. Several socio-demographic factors predicted SR-STIs. To reduce the prevalence of STIs among SAM in SSA, it is prudent to take these factors (e.g., age, condom use, employment status, HIV/AIDS knowledge) into consideration when planning health education and STIs prevention strategies among SAM.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-020-09996-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041338-5
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  • 6
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    Low educational attainment is associated with higher all-cause and cardiovascular mortality in the United States adult population
    Springer Science and Business Media LLC ; 2023
    In:  BMC Public Health Vol. 23, No. 1 ( 2023-05-16)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-05-16)
    Abstract: Educational attainment is an important social determinant of health (SDOH) for cardiovascular disease (CVD). However, the association between educational attainment and all-cause and CVD mortality has not been longitudinally evaluated on a population-level in the US, especially in individuals with atherosclerotic cardiovascular disease (ASCVD). In this nationally representative study, we assessed the association between educational attainment and the risk of all-cause and cardiovascular (CVD) mortality in the general adult population and in adults with ASCVD in the US. Methods We used data from the 2006–2014 National Death Index-linked National Health Interview Survey for adults ≥ 18 years. We generated age-adjusted mortality rates (AAMR) by levels of educational attainment ( 〈  high school (HS), HS/General Education Development (GED), some college, and ≥ College) in the overall population and in adults with ASCVD. Cox proportional hazards models were used to examine the multivariable-adjusted associations between educational attainment and all-cause and CVD mortality. Results The sample comprised 210,853 participants (mean age 46.3), representing ~ 189 million adults annually, of which 8% had ASCVD. Overall, 14.7%, 27%, 20.3%, and 38% of the population had educational attainment  〈  HS, HS/GED, Some College, and ≥ College, respectively. During a median follow-up of 4.5 years, all-cause age-adjusted mortality rates were 400.6 vs. 208.6 and 1446.7 vs. 984.0 for the total and ASCVD populations for 〈  HS vs ≥ College education, respectively. CVD age adjusted mortality rates were 82.1 vs. 38.7 and 456.4 vs 279.5 for the total and ASCVD populations for 〈  HS vs ≥ College education, respectively. In models adjusting for demographics and SDOH,  〈  HS (reference =  ≥ College) was associated with 40–50% increased risk of mortality in the total population and 20–40% increased risk of mortality in the ASCVD population, for both all-cause and CVD mortality. Further adjustment for traditional risk factors attenuated the associations but remained statistically significant for  〈  HS in the overall population. Similar trends were seen across sociodemographic subgroups including age, sex, race/ethnicity, income, and insurance status. Conclusions Lower educational attainment is independently associated with increased risk of all-cause and CVD mortality in both the total and ASCVD populations, with the highest risk observed for individuals with  〈  HS education. Future efforts to understand persistent disparities in CVD and all-cause mortality should pay close attention to the role of education, and include educational attainment as an independent predictor in mortality risk prediction algorithms.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-023-15621-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2041338-5
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  • 7
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    MULTIDIMENSIONAL POVERTY AS A SOCIAL DETERMINANT OF HEALTH FOR ATHEROSCLEROTIC CARDIOVASCULAR DISEASE IN THE UNITED STATES
    Elsevier BV ; 2022
    In:  Journal of the American College of Cardiology Vol. 79, No. 9 ( 2022-03), p. 1432-
    Details
    In: Journal of the American College of Cardiology, Elsevier BV, Vol. 79, No. 9 ( 2022-03), p. 1432-
    Type of Medium: Online Resource
    ISSN: 0735-1097
    URL: Article
    DOI: 10.1016/S0735-1097(22)02423-8
    RVK:
    XA 17760
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 1468327-1
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  • 8
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    Abstract 11520: Cost-Related Medication Nonadherence in Adults with Diabetes Mellitus in the United States
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. Suppl_1 ( 2021-11-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
    Abstract: Background: Health-related expenditures due to diabetes mellitus (DM) are rising in the US. Medication nonadherence is associated with worse health outcomes, particularly among individuals with DM who require uninterrupted treatment. We sought to determine whether patients with DM in the US report cost-related nonadherence (CRN), a potential consequence of rising drug costs. Methods: We used the National Health Interview Survey (2013-18), a nationally representative study, to identify participants with and without self-reported DM. Participants were considered to have experienced CRN if during the preceding year they reported skipping doses, taking less medication, or delaying filling a prescription to save money. Results: Of the 20,326 participants with DM, a weighted 14% (or 3 million annually) experienced CRN, including 9.5% skipping doses, 9.9% taking less medicine, and 11.8% delaying prescription filling to save money. Compared to those without DM (N=145,186), participants with DM reported a higher prevalence of CRN, with the largest differences being observed among non-elderly adults (Figure). Among non-elderly adults with DM, a weighted 19.4% (or 2.3 million annually) reported CRN. In multivariable logistic regression models, the main drivers of CRN among participants with DM were lack of insurance (OR 4.34, 95% CI 3.49, 5.39), younger age (OR 3.43, 95% CI 2.65, 4.44), low income (OR 1.82, 95% CI 1.58, 2.09), use of insulin (OR 1.19, 95% CI 1.04, 1.35), and unfavorable risk factor profile (OR 1.53, 95% CI 1.21, 1.93) (Table). Conclusion: In the US, 1 in 7 adults with DM reported CRN, and the burden was highest among non-elderly adults. Cost represents a serious barrier for therapy adherence among individuals with DM in the US, particularly among the most vulnerable. Removing financial barriers to accessing medications may improve adherence to essential therapies among individuals with DM, and ultimately improving outcomes.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.144.suppl_1.11520
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
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  • 9
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    Abstract 13366: Cardiovascular Risk Profile of Middle Eastern Immigrants Living in the United States
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. Suppl_1 ( 2021-11-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
    Abstract: Introduction: Middle Eastern (ME) immigrants are one of the fastest-growing groups in the US. Several studies have noted a relatively high burden of CVD in ME countries. In the US, while their risk profile has been partially described as part of immigrant studies, the burden of risk factors and ASCVD have not been studied in detail among ME immigrants. Methods: We used 2012-2018 data from the National Health Interview Survey (NHIS), a US nationally representative survey. ME origin was ascertained through self-reported region of birth. ASCVD and CVD risk factors were also self-reported. We compared these to US-born non-Hispanic white (NHW) individuals in the US, using chi-square tests and logistic regression models. Results: Among 139,778 adults included, 886 (representing 1.3 million individuals, mean age 46.8) were of ME origin, and 138,892 were US-born NHWs (representing 150 million US adults, mean age 49.3). ME participants were more likely to have higher education, lower income and be uninsured. The age-adjusted prevalence of hypertension (22.7% vs 27.8%) and obesity (22.1% vs 32%) were significantly lower in MEs vs NHWs participants, respectively. There were no significant differences between the groups in the age-adjusted prevalence of ASCVD, diabetes, hyperlipidemia, and smoking. Only physical inactivity was higher among ME individuals (Fig) . In multivariable analyses, ME participants had lower odds of hypertension (OR 0.71, 95% CI 0.61, 0.83) and obesity (OR 0.61, 95% CI 0.52, 0.72), and higher odds of physical inactivity (OR 1.30, 95% CI 1.11, 1.53), with no significant differences in the other factors or ASCVD (Fig) . Conclusions: ME immigrants in the US exhibit a more favourable cardiovascular risk profile compared to NHWs. Further studies are needed to determine whether this finding is related to lower risk, selection of a healthier ME subgroup in NHIS, or possible under-detection of cardiovascular risk factors in ME immigrants living in the US.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.144.suppl_1.13366
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
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  • 10
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    Abstract 13515: LDL-Cholesterol, Coronary Plaque, and Resilience to Coronary Atherosclerosis in a Middle-Aged Asymptomatic US Population: The Miami Heart Study at Baptist Health South Florida
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: The interplay between LDL-C and coronary plaque has not been described in contemporary, asymptomatic US cohorts undergoing CCTA assessment. Also, the prevalence of resilience to coronary atherosclerosis despite high LDL-C in the general primary prevention population is poorly understood. Methods: Cross-sectional analysis using data from the ongoing, prospective Miami Heart Study. Descriptive statistics were computed among statin-naïve participants by LDL-C levels ( 〈 70, 70-100, 100-130, 130-160, 160-190, ≥190 mg/dL) and a combined group of statin-naïve with LDL-C≥190 and statin users with LDL-C≥130 (“high LDL-C”). Study outcomes included CAC=0 vs 〉 0, any plaque on CCTA, maximal stenosis ≥50%, and ≥1 and ≥2 high-risk plaque features. Logistic regression models evaluated associations between LDL-C and the outcomes, adjusting for other risk factors. Results: The demographics and outcomes of 1,808 participants not on statin are summarized in the Table by LDL-C levels. Higher LDL-C levels were strongly and independently associated with CAC 〉 0 (fully adjusted OR for LDL≥190 vs 〈 70 mg/dL: 2.62, 95%CI 1.04, 6.60) and had a marginally significant association with any plaque (fully adjusted OR: 2.26, 95%CI 0.95, 5.37). However, among participants with LDL-C≥190, 54% had CAC=0, and 40% no plaque. Similar numbers were observed among participants with “high LDL-C” (N=159), in which 45% had CAC=0 and 35% no plaque. Among those with high LDL-C and CAC=0, approximately 28% had non-calcified plaque on CCTA, although the prevalence of high-risk plaque findings was very low. Conclusions: LDL-C is strongly associated with coronary atherosclerosis. However, in this cohort (mean age 53 years; 54% women), CAC=0 and the absence of coronary plaque were frequent findings among individuals with high LDL-C. These observations may be used to inform more personalized paradigms in ASCVD risk assessment and in the allocation of novel LDL-C-lowering therapies in this group.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.13515
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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