scholarly journals Trends in Legionnaires’ Disease-Associated Hospitalizations, United States, 2006–2010

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Gayathri Mudali ◽  
Paul E Kilgore ◽  
Abdulbaset Salim ◽  
Shawn P McElmurry ◽  
Marcus Zervos
Keyword(s):  
United States ◽  
Legionella Pneumophila ◽  
Disease Burden ◽  
International Classification Of Diseases ◽  
The United States ◽  
Community Acquired Pneumonia ◽  
Annual Incidence ◽  
Diagnostic Code ◽  
National Hospital Discharge Survey ◽  
Legionnaires Disease

Abstract Background Legionella pneumophila is a waterborne cause of both healthcare-associated and community-acquired pneumonia. Legionella pneumophila serogroup 1 is responsible for 80% of infections. There is currently limited published disease burden data on Legionnaires’ disease-associated hospitalization in the United States. Methods In this study, we estimated the annual incidence of Legionnaires’ disease-associated hospitalizations in United States and identified demographic, temporal, and regional characteristics of individuals hospitalized for Legionnaires’ disease. A retrospective study was conducted using the National Hospital Discharge Survey (NHDS) data from 2006 to 2010. The NHDS is a nationally representative US survey, which includes estimates of inpatient stays in short-stay hospitals in the United States, excluding federal, military, and Veterans Administration hospitals. All discharges assigned with the Legionnaires’ disease International Classification of Diseases 9th Clinical Modification discharge diagnostic code (482.84) were included in this study. Results We observed the annual incidence and number of Legionnaires’ disease-associated hospitalizations (per 100 000 population) in the United States by year, age, sex, race, and region. Over a 5-year period, 14 574 individuals experienced Legionnaires’ disease-associated hospitalizations in the United States The annual population-adjusted incidence (per 100 000 population) of Legionnaires’ disease-associated hospitalizations was 5.37 (95% confidence interval [CI], 5.12–5.64) in 2006, 7.06 (95% CI, 6.80–7.40) in 2007, 8.77 (95% CI, 8.44–9.11) in 2008, 17.07 (95% CI, 16.62–17.54) in 2009, and 9.66 (95% CI, 9.32–10.01) in 2010. A summer peak of Legionnaires’ disease-associated hospitalizations occurred from June through September in 2006, 2007, 2008, and 2010. Conclusions Legionnaires’ disease-associated hospitalizations significantly increased over the 5-year study period. The increasing disease burden of Legionnaires’ disease suggests that large segments of the US population are at risk for exposure to this waterborne pathogen.

scholarly journals SAT0172 UTILIZATION OF HYDROXYCHLOROQUINE AND CORTICOSTEROIDS AMONG LUPUS PATIENTS WITH INCIDENT END-STAGE RENAL DISEASE (ESRD) ONSET: A LONGITUDINAL STUDY USING USRDS REGISTRY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1027.2-1027
Author(s):  
A. R. Broder ◽  
W. Mowrey ◽  
A. Valle ◽  
B. Goilav ◽  
K. Yoshida ◽  
...  
Keyword(s):  
United States ◽  
Lupus Nephritis ◽  
Renal Disease ◽  
International Classification Of Diseases ◽  
The United States ◽  
Diagnostic Code ◽  
Prescribing Practices ◽  
Part D ◽  
Stage Renal Disease

Background:The development of ESRD due to lupus nephritis is one of the most common and serious complications of SLE. Mortality among SLE ESRD patients is 4-fold higher compared to lupus nephritis patients with preserved renal function1Mortality in SLE ESRD is also twice as high compared with non-SLE ESRD, even though SLE patients develop ESRD at a significantly younger age. In the absence of ESRD specific guidelines, medication utilization in SLE ESRD is unknown.Objectives:The objective of this study was to investigate the real-world current US-wide patterns of medication prescribing among lupus nephritis patients with new onset ESRD enrolled in the United States Renal Disease Systems (USRDS) registry. We specifically focused on HCQ and corticosteroids (CS) as the most used medications to treat SLE.Methods:Inclusion: USRDS patients 18 years and above with SLE as a primary cause of ESRD (International Classification of Diseases, 9thRevision (ICD9) diagnostic code 710.0, previously validated2). who developed ESRD between January 1st, 2006 and July 31, 2011 (to ensure at least 6 months of follow-up in the USRDS). Patients had to be enrolled in Medicare Part D (to capture pharmacy claims). The last follow-up date was defined as either the last date of continuous part D coverage or the end of the study period, Dec 31, 2013.Results:Of the 2579 patients included, 1708 (66%) were HCQ- at baseline, and 871 (34%) were HCQ+ at baseline. HCQ+ patients at baseline had a slightly lower duration of follow-up compared to HCQ- patients at baseline, median (IQR) of 2.32 (1.33, 3.97) years and 2.55 (1.44, 4.25) years, respectively, p= 0.02. During follow-up period, only 778 (30%) continued HCQ either intermittently or continuously to the last follow-up date, 1306 (51%) were never prescribed HCQ after baseline, and 495 (19%) discontinued HCQ before the last follow-up date. Of the 1801 patients who were either never prescribed or discontinued HCQ early after ESRD onset, 713 (40%) were prescribed CS to the end of the follow-up period: 55% were receiving a low dose <10mg/daily, and 43 were receiving moderate dose (10-20mg daily)Conclusion:HCQ may be underprescribed and CS may be overprescribed in SLE ESRD. Changing the current prescribing practices may improve outcomes in SLE ESRDReferences:[1]Yap DY et al., NDT 2012.[2]Broder A et al., AC&R 2016.Acknowledgments :The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.Funding: :NIH/NIAMS K23 AR068441 (A Broder), NIH/NIAMS R01 AR 057327 and K24 AR 066109 (KH Costenbader)Disclosure of Interests: :Anna R. Broder: None declared, Wenzhu Mowrey: None declared, Anna Valle: None declared, Beatrice Goilav: None declared, Kazuki Yoshida: None declared, Karen Costenbader Grant/research support from: Merck, Consultant of: Astra-Zeneca

scholarly journals Trends in hospitalizations associated with gastroenteritis among adults in the United States, 1979–1995

1999 ◽  
Vol 123 (1) ◽  
pp. 1-8 ◽  
Author(s):  
A. W. MOUNTS ◽  
R. C. HOLMAN ◽  
M. J. CLARKE ◽  
J. S. BRESEE ◽  
R. I. GLASS
Keyword(s):  
United States ◽  
Disease Burden ◽  
Risk Groups ◽  
The United States ◽  
Annual Number ◽  
Prevention Strategies ◽  
National Hospital ◽  
Hospital Discharges ◽  
National Hospital Discharge Survey ◽  
Common Illnesses

Gastroenteritis (GE) is among the most common illnesses of humans but the burden of disease, its epidemiology, and the distribution of pathogens in adults have not been fully examined. This information is needed to plan prevention strategies particularly for high-risk groups. This study is a retrospective analysis of data from the National Hospital Discharge Survey for the years 1979 through 1995 which describes the disease burden and epidemiology of hospitalizations associated with GE among adults in the United States. Diarrhoea was listed as a diagnosis on an average of 452000 hospital discharges per year representing 1·5% of all hospitalizations among adults. The annual number of GE hospitalizations has decreased by 20% from approximately 500000 in 1979 to 400000 in 1995. The aetiology of 78% of cases coded as GE was undetermined. Until the aetiology of disease can be better established, specific strategies for prevention cannot be developed.

scholarly journals The status of neurology fellowships in the United States: clinical needs, educational barriers, and future outlooks

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Harini Sarva ◽  
Gustavo A. Patino ◽  
Mehmood Rashid ◽  
James W. M. Owens ◽  
Matthew S. Robbins ◽  
...  
Keyword(s):  
United States ◽  
American Academy ◽  
Neurodegenerative Disorders ◽  
Disease Burden ◽  
Neurological Diseases ◽  
The United States ◽  
Educational Barriers ◽  
The Status

AbstractThe need for subspecialty-trained neurologists is growing in parallel with increasing disease burden. However, despite the immense burden of neurological diseases, like headache and neurodegenerative disorders, recruitment into these subspecialties remains insufficient in the United States. In this manuscript, a group of educators from the American Academy of Neurology’s A.B. Baker Section on Neurological Education sought to review and discuss the current landscape of neurology fellowships in the United States, the factors driving fellowship recruitment and the educational barriers. Moreover, suggestions to potentially improve recruitment for under-selected fellowships, which can contribute towards an alignment between neurological education and neurological needs, and future educational scenarios are discussed.

scholarly journals Annual Incidence Rates of Herpes Zoster among an Immunocompetent Population In The United States

2015 ◽  
Vol 18 (3) ◽  
pp. A232
Author(s):  
B.H. Johnson ◽  
J. Gatwood ◽  
L.A. Palmer ◽  
G. Lenhart ◽  
K. Kawai ◽  
...  
Keyword(s):  
United States ◽  
Herpes Zoster ◽  
The United States ◽  
Incidence Rates ◽  
Annual Incidence

scholarly journals Legionnaires' Disease Outbreak at a Resort in Cozumel, Mexico

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Lee M. Hampton ◽  
Laurel Garrison ◽  
Jessica Kattan ◽  
Ellen Brown ◽  
Natalia A. Kozak-Muiznieks ◽  
...  
Keyword(s):  
United States ◽  
Potable Water ◽  
Water System ◽  
Disease Outbreak ◽  
Community Acquired Pneumonia ◽  
Health Departments ◽  
Medical Providers ◽  
Cozumel Island ◽  
European Working ◽  
Legionnaires Disease

Abstract Background.  A Legionnaires' disease (LD) outbreak at a resort on Cozumel Island in Mexico was investigated by a joint Mexico-United States team in 2010. This is the first reported LD outbreak in Mexico, where LD is not a reportable disease. Methods.  Reports of LD among travelers were solicited from US health departments and the European Working Group for Legionella Infections. Records from the resort and Cozumel Island health facilities were searched for possible LD cases. In April 2010, the resort was searched for possible Legionella exposure sources. The temperature and total chlorine of the water at 38 sites in the resort were measured, and samples from those sites were tested for Legionella. Results.  Nine travelers became ill with laboratory-confirmed LD within 2 weeks of staying at the resort between May 2008 and April 2010. The resort and its potable water system were the only common exposures. No possible LD cases were identified among resort workers. Legionellae were found to have extensively colonized the resort's potable water system. Legionellae matching a case isolate were found in the resort's potable water system. Conclusions.  Medical providers should test for LD when treating community-acquired pneumonia that is severe or affecting patients who traveled in the 2 weeks before the onset of symptoms. When an LD outbreak is detected, the source should be identified and then aggressively remediated. Because LD can occur in tropical and temperate areas, all countries should consider making LD a reportable disease if they have not already done so.

Early Discharge of Patients With Venous Thromboembolism: Implications Regarding Therapy

2009 ◽  
Vol 16 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Paul D. Stein ◽  
Russell D. Hull ◽  
Fadi Matta ◽  
Abdo Y. Yaekoub
Keyword(s):  
Outpatient Treatment ◽  
Early Discharge ◽  
International Normalized Ratio ◽  
The United States ◽  
Primary Diagnosis ◽  
Low Molecular Weight ◽  
Diagnostic Code ◽  
National Hospital Discharge Survey ◽  
Number Of Patients ◽  
Duration Of Hospitalization

The purpose of this investigation is to show trends in the duration of hospitalization of patients with pulmonary embolism (PE) and deep venous thrombosis (DVT). The number of patients discharged from short-stay non-Federal hospitals throughout the United States with a primary diagnostic code for PE or DVT from 1979 through 2005 was obtained from the National Hospital Discharge Survey. By 2005, 13% of patients with PE were discharged in 1 to 2 days, 30% in 3 to 4 days, 26% in 5 to 6 days, and 31% in ≥7 days. Regarding DVT, by 2005, 26% of patients with DVT were discharged in 1 to 2 days, 34% were discharged in 3 to 4 days, 20% were discharged in 5 to 6 days, and 19% were discharged in ≥7 days. The data indicate that large proportions of patients with a primary diagnosis of PE and of DVT are being discharged before adequate heparin can be administered and before warfarin can become antithrombotic. Others have reported an increased mortality among patients with PE discharged in ≤4 days. If patients are to be discharged before adequate heparin can be administered, outpatient treatment with low-molecular-weight heparin (LMWH) for at least 5 days and until the international normalized ratio (INR) is ≥2.0 for 24 hours is recommended or extended outpatient treatment with LMWH may be considered.

Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA

2017 ◽  
Vol 48 (2) ◽  
pp. 267-288 ◽  
Author(s):  
David Marcozzi ◽  
Brendan Carr ◽  
Aisha Liferidge ◽  
Nicole Baehr ◽  
Brian Browne
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Emergency Departments ◽  
The United States ◽  
National Hospital ◽  
Patient Centered ◽  
National Hospital Discharge Survey ◽  
Delivery Of Care ◽  
The Usa

Traditional approaches to assessing the health of populations focus on the use of primary care and the delivery of care through patient-centered homes, managed care resources, and accountable care organizations. The use of emergency departments (EDs) has largely not been given consideration in these models. Our study aimed to determine the contribution of EDs to the health care received by Americans between 1996 and 2010 and to compare it with the contribution of outpatient and inpatient services using National Hospital Ambulatory Medical Care Survey and National Hospital Discharge Survey databases. We found that EDs contributed an average of 47.7% of the hospital-associated medical care delivered in the United States, and this percentage increased steadily over the 14-year study period. EDs are a major source of medical care in the United States, especially for vulnerable populations, and this contribution increased throughout the study period. Including emergency care within health reform and population health efforts would prove valuable to supporting the health of the nation.

scholarly journals The Epidemiology Of Rotavirus Diarrhea In The United States: Surveillance And Estimates Of Disease Burden

1996 ◽  
Vol 174 (Supplement 1) ◽  
pp. S5-S11 ◽  
Author(s):  
R. I. Glass ◽  
P. E. Kilgore ◽  
R. C. Holman ◽  
S. Jin ◽  
J. C. Smith ◽  
...  
Keyword(s):  
United States ◽  
Disease Burden ◽  
The United States ◽  
Rotavirus Diarrhea
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