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[PMID]:28449115
[Au] Autor:Rosenberg ES; Hall EW; Sullivan PS; Sanchez TH; Workowski KA; Ward JW; Holtzman D
[Ad] Endereço:Department of Epidemiology, Emory University Rollins School of Public Health.
[Ti] Título:Estimation of State-Level Prevalence of Hepatitis C Virus Infection, US States and District of Columbia, 2010.
[So] Source:Clin Infect Dis;64(11):1573-1581, 2017 Jun 01.
[Is] ISSN:1537-6591
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background.: Hepatitis C virus (HCV) infection is the most common chronic blood-borne infection in the United States and a leading cause of morbidity and mortality. Previous analyses of the US National Health and Nutrition Examination Survey (NHANES) indicated approximately 3.6 million noninstitutionalized persons with antibody to HCV (anti-HCV). However, state-level prevalence remains less understood and cannot be estimated reliably from NHANES alone. Methods.: We used 3 publicly available government data sources to estimate anti-HCV prevalence in each US state among noninstitutionalized persons aged ≥18 years. A small-area estimation model combined indirect standardization of NHANES-based prevalence with logistic regression modeling of mortality data, listing acute or chronic HCV infection as a cause of death, from the National Vital Statistics System during 1999-2012. Model results were combined with US Census population sizes to estimate total number and prevalence of persons with antibody to HCV in 2010. Results.: National anti-HCV prevalence was 1.67% (95% confidence interval [CI], 1.53-1.90), or 3 911 800 (95% CI, 3 589 400- 4 447 500) adults in 2010. State-specific prevalence ranged from 0.71% (Illinois) to 3.34% (Oklahoma). The West census region had the highest region-specific prevalence (2.14% [95% CI, 1.96-2.48]); 10 of 13 states had rates above the national average. The South had the highest number of persons with anti-HCV (n = 1561600 [95% CI, 1 427 700-1 768 900]). The Midwest had the lowest region-specific prevalence (1.14% [95% CI, 1.04%-1.30%]). Conclusions.: States in the US West and South have been most impacted by hepatitis C. Estimates of HCV infection burden are essential to guide policy and programs to optimally prevent, detect, and cure infection.
[Mh] Termos MeSH primário: Anticorpos Anti-Hepatite C/sangue
Hepatite C Crônica/epidemiologia
Hepatite C/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
District of Columbia/epidemiologia
Monitoramento Epidemiológico
Feminino
Hepacivirus/genética
Hepacivirus/imunologia
Hepacivirus/isolamento & purificação
Hepatite C/imunologia
Hepatite C/mortalidade
Hepatite C/virologia
Hepatite C Crônica/virologia
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Inquéritos Nutricionais
Prevalência
RNA Viral/sangue
Fatores de Risco
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hepatitis C Antibodies); 0 (RNA, Viral)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1093/cid/cix202


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[PMID]:28450664
[Au] Autor:Hiro T
[Ad] Endereço:Division of Cardiology, Department of Medicine, Nihon University School of Medicine.
[Ti] Título:Report of the Annual Scientific Sessions of the American College of Cardiology (ACC), Washington DC.
[So] Source:Circ J;81(6):777-782, 2017 May 25.
[Is] ISSN:1347-4820
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:The 66 Annual Scientific Sessions and Expo of the American College of Cardiology (ACC) were held at the Walter E. Washington Convention Center, Washington DC, from March 17 to 19 , 2017. This meeting offered 23 Late-Breaking Clinical Trial (LBCT) presentations, 17 Featured Clinical Research presentations with and without LBCT, and 2,572 abstracts presented in oral and poster sessions by over 2,000 experts. This report presents the highlights of this meeting, including the opening showcase, several important LBCTs and some international joint symposiums.
[Mh] Termos MeSH primário: Cardiologia
Doenças Cardiovasculares
Sociedades Médicas
[Mh] Termos MeSH secundário: Congressos como Assunto
District of Columbia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1253/circj.CJ-17-0416


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[PMID]:29300720
[Au] Autor:Deputy NP; Dub B; Sharma AJ
[Ti] Título:Prevalence and Trends in Prepregnancy Normal Weight - 48 States, New York City, and District of Columbia, 2011-2015.
[So] Source:MMWR Morb Mortal Wkly Rep;66(5152):1402-1407, 2018 Jan 05.
[Is] ISSN:1545-861X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Women who enter pregnancy at a weight above or below normal weight, defined as a body mass index (BMI) of 18.5-24.9 (calculated as weight in kg/height in m ), are more likely to experience adverse pregnancy outcomes and to have infants who experience adverse health outcomes. For example, prepregnancy underweight (BMI <18.5) increases the risk for small-for-gestational-age births, whereas prepregnancy overweight (BMI 25.0-29.9) and obesity (BMI ≥30.0) increase risks for cesarean delivery, large-for-gestational-age births, and childhood obesity (1). Given these outcomes, Healthy People 2020 includes an objective to increase the proportion of women entering pregnancy with a normal weight from 52.5% in 2007 to 57.8% by 2020.* Because recent trends in prepregnancy normal weight have not been reported, CDC examined 2011-2015 National Vital Statistics System (NVSS) natality data, which included prepregnancy BMI. In 2015, for 48 states, the District of Columbia (DC), and New York City (NYC) combined, the prevalence of prepregnancy normal weight was 45.0%; prevalence ranged from 37.7% in Mississippi to 52.2% in DC. Among 38 jurisdictions with prepregnancy BMI data during 2011-2015, normal weight prevalence declined from 47.3% to 45.1%; declines were observed in all jurisdictions but were statistically significant for 27 jurisdictions after standardizing to the 2011 national maternal age and race/ethnicity distribution. Screening women's BMI during routine clinical care provides opportunities to promote normal weight before entering pregnancy.
[Mh] Termos MeSH primário: Índice de Massa Corporal
Peso Corporal Ideal
[Mh] Termos MeSH secundário: District of Columbia/epidemiologia
Feminino
Seres Humanos
Nascimento Vivo/epidemiologia
Cidade de Nova Iorque/epidemiologia
Gravidez
Prevalência
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180119
[Lr] Data última revisão:
180119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.15585/mmwr.mm665152a3


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[PMID]:28457620
[Au] Autor:Alqahtani SA; Luby M; Nadareishvili Z; Benson RT; Hsia AW; Leigh R; Lynch JK
[Ad] Endereço:Stroke Diagnostics and Therapeutics Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, Maryland. Electronic address: saeedqanea@hotmail.com.
[Ti] Título:Perfusion Deficits and Association with Clinical Outcome in Patients with Anterior Choroidal Artery Stroke.
[So] Source:J Stroke Cerebrovasc Dis;26(8):1755-1759, 2017 Aug.
[Is] ISSN:1532-8511
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Anterior choroidal artery (AChA) strokes have a varied pattern of tissue injury, prognosis, and clinical outcome. It is unclear whether perfusion deficit in AChA stroke is associated with the clinical outcome. This study aims to determine the frequency of perfusion abnormalities in AChA stroke and association with clinical outcome. METHODS: The study cohort was derived from ischemic stroke patients admitted to 2 stroke centers between July 2001 and July 2014. All patients received an acute magnetic resonance imaging (MRI) scan. Patients with ischemic stroke restricted to the AChA territory were included in the study. Lesion size was measured as the largest diameter on diffusion-weighted imaging (DWI) or apparent diffusion coefficient and divided into 2 groups (<20 mm or ≥20 mm). Group comparisons were performed among patients with and without perfusion abnormalities and based on diffusion diameter. Favorable clinical outcome was defined as discharge to home. RESULTS: A total of 120 patients were included in the study. Perfusion deficits were identified in 67% of patients. The admission National Institutes of Health Stroke Scale (NIHSS) was higher in patients with perfusion abnormalities (P = .027). Diameter lesion size on DWI was larger among patients with a perfusion deficit median [interquartile range], 1.63 [1.3-2.0], as compared with those without, 1.18 [1.0-1.7], P < .0001. Patients with a perfusion deficit were less likely to be discharged to home than those without (36% versus 60%, P = .013). CONCLUSIONS: Two thirds of patients with an AChA stroke have a perfusion deficit on MRI, higher admission NIHSS, and larger DWI lesion size at presentation.
[Mh] Termos MeSH primário: Circulação Cerebrovascular
Plexo Corióideo/irrigação sanguínea
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Imagem de Difusão por Ressonância Magnética
Avaliação da Deficiência
District of Columbia
Feminino
Seres Humanos
Masculino
Maryland
Meia-Idade
Alta do Paciente
Imagem de Perfusão/métodos
Recuperação de Função Fisiológica
Fatores de Risco
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/terapia
Terapia Trombolítica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28982127
[Au] Autor:Castel AD; Terzian A; Hart R; Rayeed N; Kalmin MM; Young H; Greenberg AE; DC Cohort Executive Committee
[Ad] Endereço:Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC., United States of America.
[Ti] Título:Use of national standards to monitor HIV care and treatment in a high prevalence city-Washington, DC.
[So] Source:PLoS One;12(10):e0186036, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We sought to benchmark the quality of HIV care being received by persons living with HIV in care in Washington, DC and identify individual-level and structural-level differences. Data from the DC Cohort, an observational HIV cohort of persons receiving outpatient care in DC, were used to estimate the Institute of Medicine (IOM) and Department of Health and Human Services (HHS) quality of care measures. Differences in care by demographics and clinic type were assessed using χ2 tests and multivariable regression models. Among 8,047 participants, by HHS standards, 69% of participants were retained in care (RIC), 95% were prescribed antiretroviral therapy (ART), and 84% were virally suppressed (VS). By IOM standards, 84% were in continuous care; and 78% and 80% underwent regular CD4 and VL monitoring, respectively. Screening for syphilis, chlamydia, and gonorrhea was 51%, 31%, and 26%, respectively. Older participants were 1.5 times more likely to be RIC compared to younger participants (OR: 1.5; 95% CI: 1.3, 1.8). Participants enrolled in community-based clinics were more likely to be RIC (OR: 1.7; 95% CI: 1.4, 2.0) versus those enrolled at hospital-based clinics. Older participants were more likely to achieve VS than younger participants (OR: 1.8; 95% CI: 1.5, 2.2) while Black participants were less likely compared to white participants (OR: 0.4; 95% CI: 0.3, 0.5). Despite high measures of quality of care, disparities remain. Continued monitoring of the quality of HIV care and treatment can inform the development of public health programs and interventions to optimize care delivery.
[Mh] Termos MeSH primário: Infecções por HIV/tratamento farmacológico
Qualidade da Assistência à Saúde
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/uso terapêutico
District of Columbia/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171006
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186036


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[PMID]:28961263
[Au] Autor:Pérez-Losada M; Castel AD; Lewis B; Kharfen M; Cartwright CP; Huang B; Maxwell T; Greenberg AE; Crandall KA; DC Cohort Executive Committee
[Ad] Endereço:Computational Biology Institute, Milken Institute School of Public Health, The George Washington University, Ashburn, VA, United States of America.
[Ti] Título:Characterization of HIV diversity, phylodynamics and drug resistance in Washington, DC.
[So] Source:PLoS One;12(9):e0185644, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Washington DC has a high burden of HIV with a 2.0% HIV prevalence. The city is a national and international hub potentially containing a broad diversity of HIV variants; yet few sequences from DC are available on GenBank to assess the evolutionary history of HIV in the US capital. Towards this general goal, here we analyze extensive sequence data and investigate HIV diversity, phylodynamics, and drug resistant mutations (DRM) in DC. METHODS: Molecular HIV-1 sequences were collected from participants infected through 2015 as part of the DC Cohort, a longitudinal observational study of HIV+ patients receiving care at 13 DC clinics. Sequences were paired with Cohort demographic, risk, and clinical data and analyzed using maximum likelihood, Bayesian and coalescent approaches of phylogenetic, network and population genetic inference. We analyzed 601 sequences from 223 participants for int (~864 bp) and 2,810 sequences from 1,659 participants for PR/RT (~1497 bp). RESULTS: Ninety-nine and 94% of the int and PR/RT sequences, respectively, were identified as subtype B, with 14 non-B subtypes also detected. Phylodynamic analyses of US born infected individuals showed that HIV population size varied little over time with no significant decline in diversity. Phylogenetic analyses grouped 13.5% of the int sequences into 14 clusters of 2 or 3 sequences, and 39.0% of the PR/RT sequences into 203 clusters of 2-32 sequences. Network analyses grouped 3.6% of the int sequences into 4 clusters of 2 sequences, and 10.6% of the PR/RT sequences into 76 clusters of 2-7 sequences. All network clusters were detected in our phylogenetic analyses. Higher proportions of clustered sequences were found in zip codes where HIV prevalence is highest (r = 0.607; P<0.00001). We detected a high prevalence of DRM for both int (17.1%) and PR/RT (39.1%), but only 8 int and 12 PR/RT amino acids were identified as under adaptive selection. We observed a significant (P<0.0001) association between main risk factors (men who have sex with men and heterosexuals) and genotypes in the five well-supported clusters with sufficient sample size for testing. DISCUSSION: Pairing molecular data with clinical and demographic data provided novel insights into HIV population dynamics in Washington, DC. Identification of populations and geographic locations where clustering occurs can inform and complement active surveillance efforts to interrupt HIV transmission.
[Mh] Termos MeSH primário: Infecções por HIV/virologia
HIV-1/classificação
Filogenia
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
District of Columbia
Farmacorresistência Viral
Feminino
Infecções por HIV/transmissão
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170930
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185644


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[PMID]:28910267
[Au] Autor:Gamble S; Mawokomatanda T; Xu F; Chowdhury PP; Pierannunzi C; Flegel D; Garvin W; Town M
[Ad] Endereço:Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.
[Ti] Título:Surveillance for Certain Health Behaviors and Conditions Among States and Selected Local Areas - Behavioral Risk Factor Surveillance System, United States, 2013 and 2014.
[So] Source:MMWR Surveill Summ;66(16):1-144, 2017 Sep 15.
[Is] ISSN:1545-8636
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PROBLEM: Chronic diseases and conditions (e.g., heart diseases, stroke, arthritis, and diabetes) are the leading causes of morbidity and mortality in the United States. These conditions are costly to the U.S. economy, yet they are often preventable or controllable. Behavioral risk factors (e.g., excessive alcohol consumption, tobacco use, poor diet, frequent mental distress, and insufficient sleep) are linked to the leading causes of morbidity and mortality. Adopting positive health behaviors (e.g., staying physically active, quitting tobacco use, obtaining routine physical checkups, and checking blood pressure and cholesterol levels) can reduce morbidity and mortality from chronic diseases and conditions. Monitoring the health risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services at multilevel public health points (states, territories, and metropolitan and micropolitan statistical areas [MMSA]) can provide important information for development and evaluation of health intervention programs. REPORTING PERIOD: 2013 and 2014. DESCRIPTION OF THE SYSTEM: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services and practices related to the leading causes of death and disability in the United States and participating territories. This is the first BRFSS report to include age-adjusted prevalence estimates. For 2013 and 2014, these age-adjusted prevalence estimates are presented for all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, and selected MMSA. RESULTS: Age-adjusted prevalence estimates of health status indicators, health care access and preventive practices, health risk behaviors, chronic diseases and conditions, and cardiovascular conditions vary by state, territory, and MMSA. Each set of proportions presented refers to the range of age-adjusted prevalence estimates of selected BRFSS measures as reported by survey respondents. The following are estimates for 2013. Adults reporting frequent mental distress: 7.7%-15.2% in states and territories and 6.3%-19.4% in MMSA. Adults with inadequate sleep: 27.6%-49.2% in states and territories and 26.5%-44.4% in MMSA. Adults aged 18-64 years having health care coverage: 66.9%-92.4% in states and territories and 60.5%-97.6% in MMSA. Adults identifying as current cigarette smokers: 10.1%-28.8% in states and territories and 6.1%-33.6% in MMSA. Adults reporting binge drinking during the past month: 10.5%-25.2% in states and territories and 7.2%-25.3% in MMSA. Adults with obesity: 21.0%-35.2% in states and territories and 12.1%-37.1% in MMSA. Adults aged ≥45 years with some form of arthritis: 30.6%-51.0% in states and territories and 27.6%-52.4% in MMSA. Adults aged ≥45 years who have had coronary heart disease: 7.4%-17.5% in states and territories and 6.2%-20.9% in MMSA. Adults aged ≥45 years who have had a stroke: 3.1%-7.5% in states and territories and 2.3%-9.4% in MMSA. Adults with high blood pressure: 25.2%-40.1% in states and territories and 22.2%-42.2% in MMSA. Adults with high blood cholesterol: 28.8%-38.4% in states and territories and 26.3%-39.6% in MMSA. The following are estimates for 2014. Adults reporting frequent physical distress: 7.8%-16.0% in states and territories and 6.2%-18.5% in MMSA. Women aged 21-65 years who had a Papanicolaou test during the past 3 years: 67.7%-87.8% in states and territories and 68.0%-94.3% in MMSA. Adults aged 50-75 years who received colorectal cancer screening on the basis of the 2008 U.S. Preventive Services Task Force recommendation: 42.8%-76.7% in states and territories and 49.1%-79.6% in MMSA. Adults with inadequate sleep: 28.4%-48.6% in states and territories and 25.4%-45.3% in MMSA. Adults reporting binge drinking during the past month: 10.7%-25.1% in states and territories and 6.7%-26.3% in MMSA. Adults aged ≥45 years who have had coronary heart disease: 8.0%-17.1% in states and territories and 7.6%-19.2% in MMSA. Adults aged ≥45 years with some form of arthritis: 31.2%-54.7% in states and territories and 28.4%-54.7% in MMSA. Adults with obesity: 21.0%-35.9% in states and territories and 19.7%-42.5% in MMSA. INTERPRETATION: Prevalence of certain chronic diseases and conditions, health risk behaviors, and use of preventive health services varies among states, territories, and MMSA. The findings of this report highlight the need for continued monitoring of health status, health care access, health behaviors, and chronic diseases and conditions at state and local levels. PUBLIC HEALTH ACTION: State and local health departments and agencies can continue to use BRFSS data to identify populations at risk for certain unhealthy behaviors and chronic diseases and conditions. Data also can be used to design, monitor, and evaluate public health programs at state and local levels.
[Mh] Termos MeSH primário: Doença Crônica/epidemiologia
Comportamentos Relacionados com a Saúde
Vigilância da População
Assunção de Riscos
[Mh] Termos MeSH secundário: Adulto
Idoso
Sistema de Vigilância de Fator de Risco Comportamental
District of Columbia/epidemiologia
Feminino
Guam/epidemiologia
Acesso aos Serviços de Saúde/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Prevalência
Serviços Preventivos de Saúde/utilização
Porto Rico/epidemiologia
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.15585/mmwr.ss6616a1


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[PMID]:28837549
[Au] Autor:Fang J; Ayala C; Luncheon C; Ritchey M; Loustalot F
[Ad] Endereço:Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC.
[Ti] Título:Use of Outpatient Cardiac Rehabilitation Among Heart Attack Survivors - 20 States and the District of Columbia, 2013 and Four States, 2015.
[So] Source:MMWR Morb Mortal Wkly Rep;66(33):869-873, 2017 Aug 25.
[Is] ISSN:1545-861X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Heart disease is the leading cause of death in the United States (1). Each year, approximately 790,000 adults have a myocardial infarction (heart attack), including 210,000 that are recurrent heart attacks (2). Cardiac rehabilitation (rehab) includes exercise counseling and training, education for heart-healthy living, and counseling to reduce stress. Cardiac rehab provides patients with education regarding the causes of heart attacks and tools to initiate positive behavior change, and extends patients' medical management after a heart attack to prevent future negative sequelae (3). A systematic review has shown that after a heart attack, patients using cardiac rehab were 53% (95% confidence interval [CI] = 41%-62%) less likely to die from any cause and 57% (95% CI = 21%-77%) less likely to experience cardiac-related mortality than were those who did not use cardiac rehab (3). However, even with long-standing national recommendations encouraging use of cardiac rehab (4), the intervention has been underutilized. An analysis of 2005 Behavioral Risk Factor Surveillance System (BRFSS) data found that only 34.7% of adults who reported a history of a heart attack also reported subsequent use of cardiac rehab (5). To update these estimates, CDC used the most recent BRFSS data from 2013 and 2015 to assess the use of cardiac rehab among adults following a heart attack. Overall use of cardiac rehab was 33.7% in 20 states and the District of Columbia (DC) in 2013 and 35.5% in four states in 2015. Cardiac rehab use was underutilized overall and differences were evident by sex, age, race/ethnicity, level of education, cardiovascular risk status, and by state. Increasing use of cardiac rehab after a heart attack should be encouraged by health systems and supported by the public health community.
[Mh] Termos MeSH primário: Assistência Ambulatorial/utilização
Reabilitação Cardíaca/utilização
Infarto do Miocárdio/reabilitação
Sobreviventes/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Sistema de Vigilância de Fator de Risco Comportamental
District of Columbia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170825
[St] Status:MEDLINE
[do] DOI:10.15585/mmwr.mm6633a1


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[PMID]:28827821
[Au] Autor:Levy ME; Patrick R; Gamble J; Rawls A; Opoku J; Magnus M; Kharfen M; Greenberg AE; Kuo I
[Ad] Endereço:Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States of America.
[Ti] Título:Willingness of community-recruited men who have sex with men in Washington, DC to use long-acting injectable HIV pre-exposure prophylaxis.
[So] Source:PLoS One;12(8):e0183521, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Clinical trials are currently investigating the safety and efficacy of long-acting injectable (LAI) agents as HIV pre-exposure prophylaxis (PrEP). Using National HIV Behavioral Surveillance data, we assessed the self-reported willingness of men who have sex with men (MSM) to use LAI PrEP and their preference for LAI versus daily oral PrEP. METHODS: In 2014, venue-based sampling was used to recruit MSM aged ≥18 years in Washington, DC. Participants completed an interviewer-administered survey followed by voluntary HIV testing. This analysis included MSM who self-reported negative/unknown HIV status at study entry. Correlates of being "very likely" to use LAI PrEP and preferring it to daily oral PrEP were identified using multivariable logistic regression. RESULTS: Of 314 participants who self-reported negative/unknown HIV status, 50% were <30 years old, 41% were non-Hispanic Black, 37% were non-Hispanic White, and 14% were Hispanic. If LAI PrEP were offered for free or covered by health insurance, 62% were very likely, 25% were somewhat likely, and 12% were unlikely to use it. Regarding preferred PrEP modality, 67% chose LAI PrEP, 24% chose oral PrEP, and 9% chose neither. Correlates of being very likely versus somewhat likely/unlikely to use LAI PrEP included age <30 years (aOR 1.64; 95% CI 1.00-2.68), reporting ≥6 (vs. 1) sex partners in the last year (aOR 2.60; 95% CI 1.22-5.53), previous oral PrEP use (aOR 3.67; 95% CI 1.20-11.24), and being newly identified as HIV-infected during study testing (aOR 4.83; 95% CI 1.03-22.67). Black (vs. White) men (aOR 0.48; 95% CI 0.24-0.96) and men with an income of <$20,000 (vs. ≥$75,000; aOR 0.37; 95% CI 0.15-0.93) were less likely to prefer LAI to oral PrEP. CONCLUSIONS: If LAI PrEP were found to be efficacious, its addition to the HIV prevention toolkit could facilitate more complete PrEP coverage among MSM at risk for HIV.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Homossexualidade Masculina
Aceitação pelo Paciente de Cuidados de Saúde
Profilaxia Pré-Exposição/utilização
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
District of Columbia
Seres Humanos
Masculino
Meia-Idade
Parceiros Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183521


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[PMID]:28826893
[Au] Autor:Alraies MC; Lee SY; Lipinski MJ; Buchanan K; Steinvil A; Rogers T; Koifman E; Gai J; Torguson R; Ben-Dor I; Satler LF; Pichard AD; Waksman R
[Ad] Endereço:Division of Interventional Cardiology, Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, District of Columbia.
[Ti] Título:Effect of Bleeding Risk on Type of Stent Used in Patients Presenting With Acute Coronary Syndrome.
[So] Source:Am J Cardiol;120(8):1272-1278, 2017 Oct 15.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients at high bleeding risk (HBR) are at increased risk of bleeding following percutaneous coronary intervention (PCI) with drug-eluting stents (DES) due to the need for longer dual antiplatelet duration. We sought to evaluate the likelihood of receiving DES during PCI in HBR populations and to characterize DES utilization trends over time. Consecutive patients who underwent PCI from April 2003 to September 2015 were identified. HBR is defined as patients fulfilling 1 or more of the HBR criteria: age ≥75 years, anticoagulation use at discharge, history of stroke, cancer in previous 3 years, glucocorticoid use, hemoglobin (Hgb) <11 g/dl, platelet count <100,000/mm , or creatinine clearance (CCr) <40 ml/min. Multivariate analysis was performed to identify which variables predicted DES selection. There were 10,594 patients (41.6%) who the met HBR definition. When adjusting for known risk factors, HBR patients were less likely to receive a DES compared with non-HBR patients (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.54 to 0.62, p <0.001). A preprocedural Hgb <11 g/dl had the greatest association with choosing DES during PCI (OR 0.51, 95% CI 0.45 to 0.57, p <0.001). Within the HBR patients, having 3 or more HBR criteria versus <3 HBR criteria had lower likelihood of receiving a DES (OR 0.50, 95% CI 0.44 to 0.57, p <0.001). In conclusion, presence of HBR has a significant impact upon the decision to use DES.
[Mh] Termos MeSH primário: Síndrome Coronariana Aguda/cirurgia
Stents Farmacológicos/efeitos adversos
Intervenção Coronária Percutânea/métodos
Hemorragia Pós-Operatória/etiologia
Medição de Risco/métodos
[Mh] Termos MeSH secundário: Síndrome Coronariana Aguda/diagnóstico
Idoso
District of Columbia/epidemiologia
Feminino
Seguimentos
Seres Humanos
Incidência
Masculino
Meia-Idade
Intervenção Coronária Percutânea/efeitos adversos
Hemorragia Pós-Operatória/epidemiologia
Falha de Prótese
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE



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