scholarly journals Risk behaviours by type of concurrency among young people in three STI clinics in the United States

Sexual Health ◽  
2012 ◽  
Vol 9 (3) ◽  
pp. 280 ◽  
Author(s):  
Kristen L. Hess ◽  
Pamina M. Gorbach ◽  
Lisa E. Manhart ◽  
Bradley P. Stoner ◽  
David H. Martin ◽  
...  
Keyword(s):  
Risk Factors ◽  
African American ◽  
Drug Use ◽  
Population Level ◽  
The United States ◽  
Risk Behaviours ◽  
Men And Women ◽  
Concurrent Sexual Partnerships ◽  
Sexually Transmissible Infections ◽  
African American Race

Background Concurrent sexual partnerships can increase sexually transmissible infections (STI) transmission on a population level. However, different concurrency types may be associated with differential risks for transmission. To investigate this, we describe the prevalence and correlates of four specific concurrency types. Methods: Between 2001 and 2004, 1098 young adults attending three STI clinics were interviewed and tested for STIs. Characteristics associated with concurrency types were identified using logistic regression. Results: Approximately one-third of respondents reported reactive (34%), transitional (36%), compensatory (32%) and experimental (26%) concurrency. Among men, reactive concurrency was associated with not identifying as heterosexual, drug use and having sex the same day as meeting a partner. Among women, reactive concurrency was associated with African-American race and having >3 lifetime partners. Transitional concurrency was associated with >3 lifetime partners for men and women. Among men, compensatory concurrency was associated with African-American race; among women, there were no associations with compensatory concurrency. Among men, experimental concurrency was associated with >3 lifetime partners and having sex the same day as meeting a partner. Among women, experimental concurrency was associated with not identifying as heterosexual, drug use and having sex the same day as meeting a partner. Conclusions: All concurrency types were common in this population and each was associated with a set of demographic and risk factors. Reactive and experimental concurrency types were associated with other high-risk behaviours, such as drug use.

scholarly journals Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

2020 ◽  
Vol 17 (5) ◽  
pp. 1552 ◽  
Author(s):  
Deniz Yeter ◽  
Ellen C. Banks ◽  
Michael Aschner
Keyword(s):  
Risk Factors ◽  
Early Childhood ◽  
African American ◽  
Risk Factor ◽  
Low Income ◽  
Racial Disparity ◽  
Blood Lead ◽  
Black Children ◽  
The United States ◽  
American Black

There is no safe detectable level of lead (Pb) in the blood of young children. In the United States, predominantly African-American Black children are exposed to more Pb and present with the highest mean blood lead levels (BLLs). However, racial disparity has not been fully examined within risk factors for early childhood Pb exposure. Therefore, we conducted secondary analysis of blood Pb determinations for 2841 US children at ages 1–5 years with citizenship examined by the cross-sectional 1999 to 2010 National Health and Nutrition Examination Survey (NHANES). The primary measures were racial disparities for continuous BLLs or an elevated BLL (EBLL) ≥5 µg/dL in selected risk factors between non-Hispanic Black children (n = 608) and both non-Hispanic White (n = 1208) or Hispanic (n = 1025) children. Selected risk factors included indoor household smoking, low income or poverty, older housing built before 1978 or 1950, low primary guardian education <12th grade/general education diploma (GED), or younger age between 1 and 3 years. Data were analyzed using a regression model corrected for risk factors and other confounding variables. Overall, Black children had an adjusted +0.83 µg/dL blood Pb (95% CI 0.65 to 1.00, p < 0.001) and a 2.8 times higher odds of having an EBLL ≥5 µg/dL (95% CI 1.9 to 3.9, p < 0.001). When stratified by risk factor group, Black children had an adjusted 0.73 to 1.41 µg/dL more blood Pb (p < 0.001 respectively) and a 1.8 to 5.6 times higher odds of having an EBLL ≥5 µg/dL (p ≤ 0.05 respectively) for every selected risk factor that was tested. For Black children nationwide, one in four residing in pre-1950 housing and one in six living in poverty presented with an EBLL ≥5 µg/dL. In conclusion, significant nationwide racial disparity in blood Pb outcomes persist for predominantly African-American Black children even after correcting for risk factors and other variables. This racial disparity further persists within housing, socio-economic, and age-related risk factors of blood Pb outcomes that are much more severe for Black children.

scholarly journals Re-operation within 30 days of radical cystectomy: Identifying high-risk patients and complications using ACS-NSQIP database

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rashid K. Sayyid ◽  
Diana Magee ◽  
Amanda E. Hird ◽  
Benjamin T. Harper ◽  
Eric Webb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
African American ◽  
High Risk ◽  
Radical Cystectomy ◽  
High Risk Patients ◽  
Metastatic Bladder Cancer ◽  
Risk Patients ◽  
History Of ◽  
African American Race

Introduction: Radical cystectomy (RC) is a highly morbid procedure, with 30-day complication rates approaching 31%. Our objective was to determine risk factors for re-operation within 30 days following a RC for non-metastatic bladder cancer. Methods: We included all patients who underwent a RC for non-metastatic bladder cancer using The American College of Surgeons National Surgical Quality Improvement Program database between January 1, 2007 and December 31, 2014. Logistic regression analyses were used to evaluate predictors of re-operation. Results: A total of 2608 patients were included; 5.8% of patients underwent re-operation within 30 days. On multivariable analysis, increasing body mass index (BMI) (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01–1.07), African-American race (vs. Caucasian OR 2.29; 95% CI 1.21–4.34), and history of chronic obstructive pulmonary disease (COPD) (OR 2.33; 95% CI 1.45–3.74) were significant predictors of re-operation within 30 days of RC. Urinary diversion type (ileal conduit vs. continent) and history of chemotherapy or radiotherapy within 30 days prior to RC were not. Patients who underwent re-operation within this timeframe had a significantly higher mortality rate (4.0% vs. 1.6%) and were more likely to experience cardiac (7.2% vs. 1.9%), pulmonary (23.0% vs. 3.0%), neurological (2.0% vs. 0.49%), and venous thromboembolic events (10.5% vs. 5.4%), as well as infectious complications (64.5% vs. 24.1%) with a significantly longer hospital length of stay (16.5 vs. 7.0 days). Conclusions: Recognizing increasing BMI, COPD, and African-American race as risk factors for re-operation within 30 days of RC will allow urologists to preoperatively identify such high-risk patients and prompt them to adopt more aggressive approaches to minimize postoperative surgical complications.

scholarly journals Occupational Risk Factors for Selected Cancers Among African American and White Men in the United States

2003 ◽  
Vol 93 (10) ◽  
pp. 1748-1752 ◽  
Author(s):  
Nathaniel C. Briggs ◽  
Robert S. Levine ◽  
H. Irene Hall ◽  
Otis Cosby ◽  
Edward A. Brann ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
African American ◽  
White Men ◽  
The United States ◽  
Occupational Risk ◽  
Occupational Risk Factors

Risk Factors for Delinquency and Illicit Drug Use from Adolescence to Young Adulthood

1986 ◽  
Vol 16 (1) ◽  
pp. 67-90 ◽  
Author(s):  
Denise Kandel ◽  
Ora Simcha-Fagan ◽  
Mark Davies
Keyword(s):  
Risk Factors ◽  
New York ◽  
Drug Use ◽  
Young Adulthood ◽  
Illicit Drug ◽  
Early Adulthood ◽  
New York State ◽  
Delinquent Behavior ◽  
Illicit Drug Use ◽  
Men And Women

This study examines the interrelationships and predictors of involvement in delinquent activities and illicit drug use over a nine-year interval, from adolescence (age 15–16) to young adulthood (age 24–25) in a cohort representative of adolescents formerly enrolled in grades 10 and 11 in public secondary schools in New York State (N =1,004). Persistence of illicit drug use in this period of the life-cycle is greater than for delinquency and is higher among men than among women. Convergences and divergences in intrapersonal and interpersonal predictors of drug use and delinquency are analyzed. Adult illicit drug use is much better predicted by adolescent illicit drug use, especially among men. Among women, early drug use predicts later delinquent behavior. However, illicit drug use in the period from adolescence to early adulthood selectively predicts adult participation in one type of delinquent behavior, namely theft, among men and women, but has no effect on interpersonal aggression. Different risk factors in adolescence other than drug use predict continued delinquent involvement among men and women. In particular, depression plays an important role for women and family factors for men. Lifestyle factors subsequent to adolescence, especially failure to enter the conventional roles of adulthood, such as marriage and continuous employment, are important predictors of continued illicit drug use in adulthood but not of delinquency. Delinquency among males and illicit drug use among females appear to be subject to common etiological factors and may play similar roles in the lives of young people. Convergence between the findings and results reported by others are discussed.

scholarly journals 329. Health Disparities Among HIV-Positive Patients with Kaposi’s Sarcoma

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S175-S175
Author(s):  
Sheena Knights ◽  
Susana Lazarte ◽  
Radhika Kainthla ◽  
Demi Krieger ◽  
Mitu Bhattatiry ◽  
...  
Keyword(s):  
African American ◽  
Drug Use ◽  
Cancer Diagnosis ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
The United States ◽  
T1 Stage ◽  
Race Ethnicity ◽  
Iv Drug Use

Abstract Background Kaposi’s sarcoma (KS) is an AIDS-related condition that is mediated by HHV-8. Although incidence and mortality of KS in the United States have decreased over time since the advent of HAART, there may be disparities in mortality based on geographic location and race/ethnicity, particularly African-American men in the South. Methods A retrospective electronic medical record review was conducted using integrated inpatient and outpatient data in EPIC from PHHS. We included all individuals with a diagnosis of HIV and Kaposi’s sarcoma between January 1, 2009 and December 31, 2018 based on ICD-9/10 codes. We collected demographic information, HIV history, variables related to HIV and KS diagnosis, treatment and outcomes data for each patient. We calculated hazard ratios using Cox proportional hazards modeling. Results We identified 252 patients with KS. 95% of patients were male, and the majority were MSM (men who have sex with men; 77% of all patients). 35% of patients were Hispanic, 34% were African-American and 31% were Caucasian. Over half (56%) of patients were funded through Ryan White or were uninsured. The median CD4 count and viral load at the time of cancer diagnosis were 44 and 73,450, respectively. 24% of patients were confirmed to have died by the end of the study time frame. However, due to loss to follow-up, 35% of the cohort had an unknown vital status at the time of the final chart review. Variables most strongly associated with mortality were >2 hospitalizations in the first 6 months of cancer diagnosis (aHR=4.93, P = 0.0003), IV drug use (aHR=3.61, P = 0.0009), and T1 stage of KS (aHR= 2.13, P = 0.0264). African American patients had lower survival than Caucasian or Hispanic patients, with a 5-year survival of 69%, 81% and 80% respectively, although this did not reach statistical significance (aHR 1.77, P = 0.1396). Conclusion We describe a large cohort of patients with HIV and HHV-8-related disease, who are predominantly of minority race/ethnicity, uninsured, and have advanced HIV disease. Factors associated with mortality include Black/African-American ethnicity, number of hospitalizations, IV drug use and T1 stage of KS. Our mortality analysis is limited due to high lost to follow-up rates, so we suspect overall mortality in our cohort is higher than currently reported. Disclosures Ank E. Nijhawan, MD, MPH, Gilead Sciences, Inc.: Research Grant.

scholarly journals Risk factors for cardiovascular disease among Mexican-American adults in the United States and Mexico: a comparative study

2014 ◽  
Vol 56 (2) ◽  
pp. 197 ◽  
Author(s):  
Leo S Morales ◽  
Yvonne N Flores ◽  
Mei Leng ◽  
Noémie Sportiche ◽  
Katia Gallegos-Carrillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mexican American ◽  
Hdl Cholesterol ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Men And Women ◽  
The Us ◽  
Low Hdl

 Objective. To compare cardiovascular disease (CVD) risk factors in a cohort of Mexican health workers with repre­sentative samples of US-born and Mexico-born Mexican-Americans living in the US. Materials and methods. Data were obtained from the Mexican Health Worker Cohort Study (MHWCS) in Mexico and the National Health and Nutrition Examination Survey (NHANES) IV 1999-2006 in the US. Regression analyses were used to investigate CVD risk factors. Results. In adjusted analyses, NHANES participants were more likely than MHWCS participants to have hypertension, high total cholesterol, diabetes, obesity, and abdominal obesity, and were less likely to have low HDL cholesterol and smoke. Less-educated men and women were more likely to have low HDL cholesterol, obesity, and ab­dominal obesity. Conclusions. In this binational study, men and women enrolled in the MHWCS appear to have fewer CVD risk factors than US-born and Mexico-born Mexican-American men and women living in the US.

scholarly journals Association of sexually-transmitted infection and African–American race with Streptococcus agalactiae colonization in pregnancy

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Gerald A. Capraro ◽  
Sajel Lala ◽  
Khaldia Khaled ◽  
Elizabeth Gosciniak ◽  
Brianna Saadat ◽  
...  
Keyword(s):  
Risk Factors ◽  
African American ◽  
Pregnant Women ◽  
Sexually Transmitted Infection ◽  
Antibiotic Exposure ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Independent Risk Factors ◽  
African American Race ◽  
In Pregnancy

Abstract Background Group B Streptococcus (GBS) remains a significant cause of neonatal infection, but the maternal risk factors for GBS colonization remain poorly defined. We hypothesized that there may be an association between antibiotic exposure during pregnancy and GBS colonization and/or the presence of inducible clindamycin resistance (iCLI-R) in GBS isolates from GBS-colonized pregnant women. Methods A retrospective cohort study was performed at Louisiana State University Health Sciences Center – Shreveport including demographic and clinical data from 1513 pregnant women who were screened for GBS between July 1, 2009 and December 31, 2010. Results Among 526 (34.8%) women who screened positive for GBS, 124 (23.6%) carried GBS strains with iCLI-R (GBS-iCLI-R). While antibiotic exposure, race, sexually-transmitted infection (STI) in pregnancy, GBS colonization in prior pregnancy and BMI were identified as risk factors for GBS colonization in univariate analyses, the only independent risk factors for GBS colonization were African–American race (AOR = 2.142; 95% CI = 2.092–3.861) and STI during pregnancy (AOR = 1.309; 95% CI = 1.035–1.653). Independent risk factors for GBS-iCLI-R among women colonized with GBS were non-African–American race (AOR = 2.13; 95% CI = 1.20–3.78) and younger age (AOR = 0.94; 95% CI = 0.91–0.98). Among GBS-colonized women with an STI in the current pregnancy, the only independent risk factor for iCLI-R was Chlamydia trachomatis infection (AOR = 4.31; 95% CI = 1.78–10.41). Conclusions This study identified novel associations for GBS colonization and colonization with GBS-iCLI-R. Prospective studies will improve our understanding of the epidemiology of GBS colonization during pregnancy and the role of antibiotic exposure in alterations of the maternal microbiome.

scholarly journals Mortality of Dandy-Walker syndrome in the United States: Analysis by race, gender, and insurance status

2015 ◽  
Vol 6 (02) ◽  
pp. 182-185 ◽  
Author(s):  
Shearwood McClelland ◽  
Onyinyechi I. Ukwuoma ◽  
Scott Lunos ◽  
Kolawole S. Okuyemi
Keyword(s):  
African American ◽  
Hospital Volume ◽  
Private Insurance ◽  
The United States ◽  
Insurance Status ◽  
Discharge Disposition ◽  
Csf Drainage ◽  
Operative Care ◽  
Admission Type ◽  
African American Race

ABSTRACT Background: Dandy-Walker syndrome (DWS) is a congenital disorder often diagnosed in early childhood. Typically manifesting with signs/symptoms of increased intracranial pressure, DWS is catastrophic unless timely neurosurgical care can be administered via cerebrospinal fluid (CSF) drainage. The rates of mortality, adverse discharge disposition (ADD), and CSF drainage in DWS may not be uniform regardless of race, gender or insurance status; such differences could reflect disparities in access to neurosurgical care. This study examines these issues on a nationwide level. Materials and Methods: The Kids’ Inpatient Database spanning 1997-2003 was used for analysis. Only patients admitted for DWS (ICD-9-CM = 742.3) were included. Multivariate analysis was adjusted for several variables, including patient age, race, sex, admission type, primary payer, income, and hospital volume. Results: More than 14,000 DWS patients were included. Increasing age predicted reduced mortality (OR = 0.87; P < 0.05), ADD (OR = 0.96; P < 0.05), and decreased likelihood of receiving CSF drainage (OR = 0.86; P < 0.0001). Elective admission type predicted reduced mortality (OR = 0.29; P = 0.0008), ADD (OR = 0.68; P < 0.05), and increased CSF drainage (OR = 2.02; P < 0.0001). African-American race (OR = 1.20; P < 0.05) and private insurance (OR = 1.18; P < 0.05) each predicted increased likelihood of receiving CSF drainage, but were not predictors of mortality or ADD. Gender, income, and hospital volume were not significant predictors of DWS outcome. Conclusion: Increasing age and elective admissions each decrease mortality and ADD associated with DWS. African-American race and private insurance status increase access to CSF drainage. These findings contradict previous literature citing African-American race as a risk factor for mortality in DWS, and emphasize the role of private insurance in obtaining access to potentially lifesaving operative care.

Abstract 371: High On-Treatment Residual Platelet Reactivity Post--Percutaneous Coronary Intervention in Patients Loaded with High-Dose Clopidogrel: Impact of Diabetes, Age, African-American Race and Presentation Acuity on Antiplatelet Hyporesponse

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Sandeep Nathan ◽  
Janet Karol ◽  
Auddie Sweiss ◽  
Vikrant Jagadeesan ◽  
Narayan Saha ◽  
...  
Keyword(s):  
Risk Factors ◽  
African American ◽  
Platelet Reactivity ◽  
Coronary Intervention ◽  
Platelet Inhibition ◽  
Great Variability ◽  
High Dose ◽  
Inhibition Of Platelet Aggregation ◽  
Percutaneous Coronary ◽  
African American Race

Background: High residual platelet reactivity (HRPR) on clopidogrel is variably defined and linked with factors such as age, race, genetics and diabetes (DM). We investigated the prevalence of HRPR and validated its link to reported risk factors in a high-risk PCI population using published definitions. Methods: 127 PCI pts had prospective platelet inhibition testing via the Accumetrics VerifyNow P2Y12 platform, 24 hrs post-600 mg clopidogrel po. Inhibition of platelet aggregation (IPA) and residual platelet reactivity (P2Y12-reactivity units, PRU) were analyzed on continuous and dichotomous scales with varying data-supported cutoff values: PRU<230, <208; IPA<10%. Predictors of HRPR were analyzed. Results: In 127 pts (age 64 ± 11, DM 50.4%, male 63.7%) mean PRU was 198.0 ± 107 (39.3% ± 30.2% IPA). Using cutoffs of PRU > 230, PRU > 208 and IPA < 10%, HRPR was seen in 42.5%, 48.0% and 24.4% of pts respectively. (Fig 1) DM (220 +/-114.3 vs 177+/-97, P=0.022) and age > 65 yrs (177+ 107 vs 219 + 106, P=0.028) were predictive of high residual platelet reactivity (HRPR) and increasing age was continuously correlated with HRPR (r=0.184, p=0.038). 70.1% of pts were African American (AA) and 34.6% presented with STEMI/ACS but neither factor correlated with HRPR. Conclusions: HRPR on clopidogrel was highly prevalent post-PCI but with great variability based on definition. DM and older age were linked with HRPR but several other risk factors. These data suggest limited predictability of HRPR based on published metrics of risk.

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