Department of Epidemiology

MS


January 14, 2021

Outcomes of Beta-Hemolytic Streptococcal Necrotizing Skin and Soft Tissue Infections and the Impact of Clindamycin Resistance

Background: Beta-hemolytic streptococci are frequently implicated in necrotizing soft tissue infections (NSTI). Clindamycin administration may improve outcomes in patients with serious streptococcal infections. However, clindamycin resistance is growing worldwide, and resistance patterns in NSTI and their impact on outcomes are unknown. Methods: Between 2015 and 2018, NSTI patients at a quaternary referral center were followed…


Identifying patient level factors of prone positioning therapy

BACKGROUND: Acute Respiratory Distress Syndrome (ARDS) is an important cause of respiratory failure associated with high mortality and morbidity. Prone positioning (proning) is a proven therapy for ARDS and is strongly recommended by the American Thoracic Society guidelines. Despite this, it is vastly underutilized in eligible patients. We sought to determine the patient-level factors associated…


Patient-reported receipt of goal-concordant care among seriously ill outpatients – prevalence and associated factors

Goal-concordant care is an important indicator of high-quality care in serious illness. We sought to estimate the prevalence of patient-reported receipt of goal-concordant care among seriously ill outpatients and identify factors associated with absence of patient-reported goal-concordance. We analyzed enrollment surveys from a multi-center cluster-randomized trial of outpatients with serious illness. Patients reported their prioritized…


Validity of Identification Methods of Lower Extremity Amputation in the Veterans Health Administration Electronic Medical Records

It is not currently known what the best method to identify individuals with lower extremity amputation (LEA) is. The purpose of this study is to determine the positive predictive value (PPV) of algorithms used to identify patients with LEA using Veterans Health Administration (VHA) electronic medical records (EMR) and to determine if PPV varies by…


Exercise Partially Explains the Impact of Body Mass Index on Disease Activity in Ankylosing Spondylitis

Background. Ankylosing spondylitis (AS) patients have elevated cardiovascular (CV) morbidity and mortality compared to general population comparators of the same age and sex. Although obesity is an important and modifiable CV risk factor, there are few prospective studies addressing the impact of higher body mass index (BMI) on clinical outcomes in AS. The aim of…


Factors associated with reduced lung function in adolescents living with HIV in Nairobi, Kenya

Background: Over 5 million children and adolescents are living with HIV (ALWH) worldwide as a result of perinatally-acquired disease. Recent data support high prevalence of chronic respiratory symptoms in this population and a predominant phenotype of irreversible airflow obstruction. The objective of this study was to better understand factors associated with chronic lung disease in…


The impact of short message service reminders on returning to test for HIV at a community center in Seattle, WA

Objectives: Using data from Gay City, a community testing center in Seattle, we assessed the impact of short message service (SMS) text reminders on returning for a second HIV test. In addition, we investigated whether certain client characteristics were associated with return. Methods: We evaluated data on HIV testing between September 2016 and December 2019….


Predicting individual-specific HIV survival functions – motivation, implementation, and potential applications.

Immense progress has been made in the development and delivery of HIV prevention interventions worldwide, and that is reflected in the trends of global HIV epidemic metrics. However, such a wide perspective overlooks relapses in several regions and numerous concentrated epidemics among certain subpopulations. Risk of HIV varies substantially across geographic, temporal, and social space….


Impact of FDA advisories on smoking cessation for Veterans with chronic obstructive pulmonary disease

Many persons with chronic obstructive pulmonary disease (COPD) require medication to quit smoking, yet few receive highly effective therapy with varenicline. One likely barrier is historical Food and Drug Administration safety advisories for psychiatric risk, which were associated with reduced varenicline prescribing nationwide. It is unknown whether prescribers avoided varenicline even among persons with high…


Predictors of Pediatric In-Hospital Recurrent Cardiac Arrest

In-hospital pediatric cardiac arrest is an important cause of morbidity and mortality. Approximately 16,000 children receive cardiopulmonary resuscitation (CPR) in the United States each year. Patients who suffer more than one cardiac arrest event are at a particularly increased risk of mortality, with survival to hospital discharge estimated to be 41-50%. Identification of patients who…



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