Publications by authors named "Deyu Pan"

51 Publications

Schizophrenia hospitalization in the US 2005-2014: Examination of trends in demographics, length of stay, and cost.

Medicine (Baltimore) 2021 Apr;100(15):e25206

Health Policy and Leadership, School of Public Health, Loma Linda University, Los Angeles CA.

Abstract: Primarily we aimed to examine the crude and standardized schizophrenia hospitalization trend from 2005 to 2014. We hypothesized that there will be a statistically significant linear trend in hospitalization rates for schizophrenia from 2005 to 2014. Secondarily we also examined trends in hospitalization by race/ethnicity, age, gender, as well as trends in hospitalization Length of Stay (LOS) and inflation adjusted cost.In this observational study, we used Nationwide Inpatient Sample data and International Classification of Diseases, Eleventh Revisions codes for Schizophrenia, which revealed 6,122,284 cases for this study. Outcomes included crude and standardized hospitalization rates, race/ethnicity, age, cost, and LOS. The analysis included descriptive statistics, indirect standardization, Rao-Scott Chi-Square test, t-test, and adjusted linear regression trend.Hospitalizations were most prevalent for individuals ages 45-64 (38.8%), African Americans were overrepresented (25.8% of hospitalizations), and the gender distribution was nearly equivalent. Mean LOS was 9.08 days (95% confidence interval 8.71-9.45). Medicare was the primary payer for most hospitalizations (55.4%), with most of the costs ranging from $10,000-$49,999 (57.1%). The crude hospitalization rates ranged from 790-1142/100,000 admissions, while the US 2010 census standardized rates were 380-552/100,000 from 2005-2014. Linear regression trend analysis showed no significant difference in trend for race/ethnicity, age, nor gender (P > .001). The hospitalizations' overall rates increased while LOS significantly decreased, while hospitalization costs and Charlson's co-morbidity index increased (P < .001).From 2005-2014, the overall US hospitalization rates significantly increased. Over this period, observed disparities in hospitalizations for middle-aged and African Americans were unchanged, and LOS has gone down while costs have gone up. Further studies addressing the important disparities in race/ethnicity and age and reducing costs of acute hospitalization are needed.
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http://dx.doi.org/10.1097/MD.0000000000025206DOI Listing
April 2021

Factor structure, internal reliability, and construct validity of the Brief Resilience Scale (BRS): A study on persons with serious mental illness living in the community.

Psychol Psychother 2021 Mar 22. Epub 2021 Mar 22.

Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, Iowa, USA.

Objectives: Resilience, the ability to bounce back from a stressful situation, is a valuable asset for aiding adults with serious mental illness (SMI) in navigating the recovery process. People with SMI experience stress, including traumatic experiences at disproportionate rates. The purposes of this study were to examine the factor structure, internal reliability, and construct validity of the Brief Resilience Scale (BRS) among adults with SMI living in the community.

Design: A cross-sectional survey design was used. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and correlational analyses were employed.

Methods: Three hundred fifteen adults with SMI were recruited for two studies (Sample 1, n = 122; Sample 2, n = 193) from three states. All participants completed the BRS along with nearly identical positive psychology- and psychopathology-related measures.

Results: EFA revealed the BRS was unidimensional and explained 61.20% of the variance. Results from seven CFA models suggested a bifactor structure for the BRS, which fit the data best. Internal reliability of the BRS was computed to be within acceptable ranges (α = .87, ω = .90). The BRS was positively correlated with measures of positive coping and life satisfaction, providing convergent validity. Divergent validity was supported by negative correlations between the BRS and measures of psychiatric symptoms, succumbing, and self-stigma.

Conclusions: The BRS is a valid measure that can be used by clinical and research professionals to assess levels of resilience in adults with SMI at baseline and across time.

Practitioner Points: The Brief Resilience Scale (BRS) was developed to measure a person's ability to bounce back from stressful situations. The BRS was examined in adults with serious mental illness living in the community. The BRS presented a bifactor structure measuring resilience (an outcome) and correlated with positive psychology- and psychopathology-related measures. The BRS can be used by practitioners to assess levels of resilience in their clients at baseline and over time to evaluate the effectiveness of therapeutic interventions.
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http://dx.doi.org/10.1111/papt.12336DOI Listing
March 2021

How Clinically Relevant Is C-Reactive Protein for Blacks with Metabolic Syndrome to Predict Microalbuminuria?

Metab Syndr Relat Disord 2021 02 3;19(1):39-47. Epub 2020 Sep 3.

Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.

The metabolic syndrome (MetS) is associated with elevated urinary albumin (UA) excretion and C-reactive protein (CRP). However, potential differences in CRP levels on the association between individual components of the MetS and microalbuminuria (MA; 30-300 μg/mL) and/or UA (0-300 μg/mL) by race/ethnicity is unknown. We analyzed National Health and Nutrition Examination Surveys (NHANES) data, (1999-2010) for adults (≥20 years of age) with the MetS ( = 5700). The Sobel-Goodman mediation test examined the influence of CRP on the association between individual MetS components and both MA and UA by race/ethnicity. We applied machine learning models to predict UA. CRP mediated the association between waist circumference (WC) and MA in Whites and Hispanics but not in Blacks. However, in general, the proportion of the total effect of MetS components on UA, mediated by CRP, was: 11% for high-density lipoprotein cholesterol (HDL-C) and 40% for WC ( < 0.001). In contrast to MA, the mediation effect of CRP for WC and UA was highest for Blacks (94%) compared with Whites (55%) or Hispanics (18%),  < 0.05. The prediction of an elevated UA concentration was increased in Blacks (∼51%) with the MetS when CRP was added to the random forest model. CRP mediates the association between UA and both HDL-C and WC in Whites and Blacks and between UA and WC in Hispanics. Moreover, the machine learning approach suggests that the incorporation of CRP may improve model prediction of UA in Blacks. These findings may favor screening for CRP in persons with the MetS, particularly in Blacks.
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http://dx.doi.org/10.1089/met.2019.0121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891189PMC
February 2021

Reversal of age-associated oxidative stress in mice by PFT, a novel kefir product.

Int J Immunopathol Pharmacol 2020 Jan-Dec;34:2058738420950149

Department of Preventive and Social Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.

Introduction: Oxidative stress is a key contributor to aging and age-related diseases. In the present study, we examine the protective effects of PFT, a novel kefir product, against age-associated oxidative stress using aged (10-month-old) mice.

Methods: Mice were treated with PFT orally at a daily dose of 2 mg/kg body weight over 6 weeks, and antioxidant status, protein oxidation, and lipid peroxidation were studied in the brain, liver, and blood.

Results: PFT supplementation significantly reduced the oxidative stress biomarkers malondialdehyde (MDA) and nitric oxide; reversed the reductions in glutathione (GSH) levels, total antioxidant capacity (TAC), and anti-hydroxyl radical (AHR) content; enhanced the antioxidant enzyme activities of glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD); inhibited the liver enzyme levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT); significantly reduced triglyceride (TG), total cholesterol (TC), and low density lipoprotein (LDL) levels; and significantly elevated high density lipoprotein (HDL) levels. Interestingly, PFT supplementation reversed the oxidative changes associated with aging, thus bringing levels to within the limits of the young control mice in the brain, liver, and blood. We also note that PFT affects the redox homeostasis of young mice and that it is corrected post-treatment with PFT.

Conclusion: Our findings show the effectiveness of dietary PFT supplementation in modulating age-associated oxidative stress in mice and motivate further studies of PFT's effects in reducing age-associated disorders where free radicals and oxidative stress are the major cause.
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http://dx.doi.org/10.1177/2058738420950149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7466882PMC
September 2020

Helmet use and bicycle-related trauma injury outcomes.

Brain Inj 2019 12;33(13-14):1597-1601. Epub 2019 Sep 12.

David Geffen School of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA.

: It is essential to identify factors that predict helmet use, so as to mitigate the injury and mortality from bicycle accidents.: To examine the relationship between helmet use and the bicycle-related trauma injury outcomes among bicyclists with head/neck injury in the US.: Data from the 2002-2012 National Trauma Data Bank were used, including all trauma bicycle riders involved in bicycle-related accidents whose primary reason for the hospital or Intensive Care Unit stay was head or neck injury. Using multiple logistic regression, the association between helmet use, Injury severity score (ISS), length of stay in hospital (HLOS) and Intensive Care Unit (ICULOS), and mortality was examined.: Of the 76,032 bicyclists with head/neck injury, 22% worn helmets. The lowest was among Blacks, Hispanics, and <17 years old. Wearing a helmet significantly reduces injury severity, HLOS, ICULOS, and mortality (i.e total and in-hospital). Males had a severe injury, longer HLOS, ICULOS, and higher mortality than female. Blacks and Hispanics had longer HLOS and ICULOS and higher total mortality than Whites, but had a similar chance for in-hospital mortality.: More effort is needed to enhance helmet use among at-risk bicycle riders, which may reduce injury severity, HLOS, ICULOS, and mortality.
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http://dx.doi.org/10.1080/02699052.2019.1650201DOI Listing
September 2020

Dietary baker's yeast sensitizes Ehrlich mammary adenocarcinoma to paclitaxel in mice bearing tumor.

Oncol Rep 2019 Jun 10;41(6):3155-3166. Epub 2019 Apr 10.

Department of Zoology, Faculty of Science, University of Mansoura, Mansoura 35516, Egypt.

Baker's yeast, Saccharomyces cerevisiae, has been shown to sensitize a variety of breast cancer cell (BCC) lines to paclitaxel chemotherapy in vitro. The present study evaluated the ability of S. cerevisiae to sensitize BCCs to paclitaxel in animals bearing Ehrlich ascites carcinoma (EAC). Mice bearing EAC were intratumorally injected with dead S. cerevisiae (1x107 cells/ml) in the presence or absence of low- and high-dose paclitaxel [paclitaxel-L, 2 mg/kg body weight (BW) and paclitaxel-H, 10 mg/kg BW, respectively]. At 30 days post tumor inoculation, co-treatment with yeast plus paclitaxel-L showed improvements over paclitaxel-H alone, as measured by tumor weight (-64 vs. -53%), DNA damage (+79 vs. +62%), tumor cell apoptosis (+217 vs. +177%), cell proliferation (-56 vs. -42%) and Ki-67 marker (+95 vs. +40%). Histopathology and ultra-structural examinations showed that yeast plus paclitaxel-L enhanced apoptosis in EAC more than paclitaxel-H alone and caused comparable tumor necrosis. We conclude that baker's yeast may be used with low-dose chemotherapy to achieve the same potency as high-dose chemotherapy in mice bearing EAC. This suggests that baker's yeast may be an anticancer adjuvant and may have clinical implications for the treatment of breast cancer.
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http://dx.doi.org/10.3892/or.2019.7107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489018PMC
June 2019

Association of Psychiatric Diagnostic Conditions with Hospital Care Outcomes of Patients with Orthopedic Injuries.

Perm J 2018 ;22:17-120

Professor of Orthopedic Surgery at the Charles R Drew University of Medicine and Science and at the David Geffen School of Medicine at the University of California, Los Angeles, and an Orthopedic Surgeon at the Martin Luther King, Jr Outpatient Center and Community Hospital.

Context: Psychiatric comorbidity is common in orthopedic injury, but the effects on hospital care outcomes have been identified only generally.

Objective: To quantify psychiatric comorbidity and its outcome effects in a large, multicenter population of inpatients with orthopedic injuries.

Design: Retrospective analysis of patient discharge data from 507 California hospitals from 2001 to 2010. Study sample included orthopedic diagnoses using International Classification of Diseases codes for major pelvic and lower extremity injuries in patients older than age 17 years. From the injury data, we extracted psychiatric diagnoses, alcoholism, substance abuse, and sociodemographic characteristics.

Main Outcome Measures: Length of stay, surgical complications, and inpatient deaths.

Results: The entire injury admissions represented about 1.9% of all hospital admissions and were predominantly older than age 64 years, white, and women with conventional health care insurance. The most common comorbidity in the patients with injury was psychiatric illness (24.7%). The most common psychiatric diagnoses in orthopedic injury admissions were dementia (14.3%) and depression (6.9%) without association. Compared with the injury admissions with no psychiatric diagnosis, admissions with psychiatric diagnosis had higher odds of a hospital stay of 7 or more days, surgical treatment complications, and inhospital death.

Conclusion: Psychiatric comorbidity adversely affects several hospital outcomes in patients with orthopedic injuries: Length of stay, surgical complications, and inpatient mortality. In low-income populations, the adverse psychiatric effects are incrementally worse. The adverse effects of psychiatric comorbidity, particularly dementia and depression, on hospital outcomes should stimulate improved psychiatric care of many patients at risk of poor clinical outcomes.
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http://dx.doi.org/10.7812/TPP/17-120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922806PMC
December 2018

Association of Psychiatric Diagnostic Conditions with Hospital Care Outcomes of Patients with Orthopedic Injuries.

Perm J 2018 ;22:17-120

Professor of Orthopedic Surgery at the Charles R Drew University of Medicine and Science and at the David Geffen School of Medicine at the University of California, Los Angeles, and an Orthopedic Surgeon at the Martin Luther King, Jr Outpatient Center and Community Hospital.

Context: Psychiatric comorbidity is common in orthopedic injury, but the effects on hospital care outcomes have been identified only generally.

Objective: To quantify psychiatric comorbidity and its outcome effects in a large, multicenter population of inpatients with orthopedic injuries.

Design: Retrospective analysis of patient discharge data from 507 California hospitals from 2001 to 2010. Study sample included orthopedic diagnoses using International Classification of Diseases codes for major pelvic and lower extremity injuries in patients older than age 17 years. From the injury data, we extracted psychiatric diagnoses, alcoholism, substance abuse, and sociodemographic characteristics.

Main Outcome Measures: Length of stay, surgical complications, and inpatient deaths.

Results: The entire injury admissions represented about 1.9% of all hospital admissions and were predominantly older than age 64 years, white, and women with conventional health care insurance. The most common comorbidity in the patients with injury was psychiatric illness (24.7%). The most common psychiatric diagnoses in orthopedic injury admissions were dementia (14.3%) and depression (6.9%) without association. Compared with the injury admissions with no psychiatric diagnosis, admissions with psychiatric diagnosis had higher odds of a hospital stay of 7 or more days, surgical treatment complications, and inhospital death.

Conclusion: Psychiatric comorbidity adversely affects several hospital outcomes in patients with orthopedic injuries: Length of stay, surgical complications, and inpatient mortality. In low-income populations, the adverse psychiatric effects are incrementally worse. The adverse effects of psychiatric comorbidity, particularly dementia and depression, on hospital outcomes should stimulate improved psychiatric care of many patients at risk of poor clinical outcomes.
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http://dx.doi.org/10.7812/TPP/17-120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922806PMC
December 2018

Baker's Yeast Induces Apoptotic Effects and Histopathological Changes on Skin Tumors in Mice.

Cogent Med 2018 22;5(1). Epub 2018 Feb 22.

Department of Medical Physiology, National Research Centre, Cairo, Egypt, Charles Drew University of Medicine and Science, Los Angeles, California, USA.

The current study investigates the apoptotic effect of Baker's yeast () on chemically-induced skin cancer in mice. Intra-tumoral treatment with yeast caused: increases in Ca in skin homogenate, modulated the intrinsic/extrinsic pathways by downregulating Bcl-2 and FasL, upregulating Bax, and increased the expression of cytochrome-c and caspases 9, 8, and 3. Histopathological changes were detected, including mild dysplasia, atypia, tumor regression, and absence of basaloid cell proliferation. No toxic effects were detected, as examined by histopathological, biochemical, and body weight analysis. These results show that yeast exerts anti-skin cancer activity, suggesting its possible use for treatment of human skin cancer.
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http://dx.doi.org/10.1080/2331205X.2018.1437673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6516756PMC
February 2018

Health Disparities in Patients with Congestive Heart Failure Exacerbations in Los Angeles County.

Emerg Med Investig 2018 20;6(2). Epub 2018 Jun 20.

College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA.

Background: 1.1.Congestive Heart Failure (CHF) is a leading cause of death in the USA, with over 500,000 new cases diagnosed each year. While rates of CHF exacerbation across all races and ethnicities decreased from 2005 to 2009, the number of Black patients with CHF exacerbation who present in Los Angeles (L. A.) County Emergency Departments (ED) remained the highest. We examine disparities in CHF exacerbation rates in L. A. County, and in Los Angeles Service Planning Area (SPA) 6, and compare CHF-related outcomes, and the disposition of these patients post-ED visit.

Methods: 1.2.This is a retrospective analysis using the Office of Statewide Health Planning and Development (OSHPD) Emergency Department, and Ambulatory Surgery Center database from 2005 to 2009. We used the following variables: congestive heart failure, ICD-9 code 428.0, age, gender, race/ethnicity, insurance status, and disposition. Univariate and descriptive statistics identified distributions of the study variables. There were a total of 13,766 in the study population.

Results: 1.3.SPA 6 had higher hospitalization rates across all races and ethnicities, compared to L.A. County as a whole. Blacks constitute 9.1% of the County population, but represented 32% of patients diagnosed with CHF in the ED. Only about 10% of L. A. County's population resides in SPA 6, yet over 22% of the entire County's CHF patients reside there.

Conclusions: 1.4.CHF continues to disproportionately affect Black individuals in L.A. County, and younger adults in SPA 6. Our results indicate that residing in this service planning area, in addition to race, can predict greater likelihood of presenting with CHF exacerbation in the ED, and greater likelihood of hospitalization. Future research on the association of CHF exacerbation with different sociodemographic measures among minority, underserved and disadvantaged patients is needed. These can identify and help mitigate inequities and weaknesses in our health care system, which are manifest through stark health disparities among different racial, ethnic and socioeconomic groups.
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http://dx.doi.org/10.29011/2475-5605.000076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499488PMC
June 2018

A Racial Comparison of Differences between Self-Reported and Objectively Measured Physical Activity among US Adults with Diabetes.

Ethn Dis 2017 7;27(4):403-410. Epub 2017 Dec 7.

Department of Internal Medicine, Charles R. Drew University of Medicine & Science, Los Angeles, CA.

Objective: To investigate: 1) the racial/ethnic disparities in meeting the recommended physical activity as measured by subjective vs objective measures in a national sample of individuals with type 2 diabetes mellitus; and 2) the racial/ethnic differences with respect to the magnitude of the discrepancy between self-reported and objectively measured moderate-to-vigorous intensity aerobic physical activity (MVPA).

Methods: We used data from the National Health and Nutrition Examination Survey (NHANES) 2003-06 to calculate and compare the percentage of individuals with diabetes who achieved the recommended levels of physical activity as measured by subjective self-report (500 metabolic equivalents (MET)-minutes/week) and objective accelerometer measurement (150 minutes per week of MVPA) across racial/ethnic groups.

Results: 71.2%, 15.7%, and 13.1% of participants were White, African American, and Hispanic, respectively. Based on self-report, 67.1%, 39.2%, and 55.1% of Whites, African Americans, and Hispanics, respectively, met the 500 MET-minutes/week threshold of physical activity (P<.0001). Objective measurement by accelerometer showed that 44.2%, 42.6%, and 65.1% of Whites, African Americans, and Hispanics, respectively, met the threshold (P<.0003).

Conclusions: Many individuals with type 2 diabetes mellitus did not meet the recommended physical activity thresholds. African Americans had the lowest proportion of meeting both the self-reported and objectively measured thresholds. White patients with diabetes overestimated frequency of their physical activity, while their Hispanic counterparts significantly underestimated it. Also, the gap between the two measures of MVPA was largest among Hispanics.
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http://dx.doi.org/10.18865/ed.27.4.403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720950PMC
July 2019

An updated meta-analysis of pioglitazone exposure and bladder cancer and comparison to the drug's effect on cardiovascular disease and non-alcoholic steatohepatitis.

Diabetes Res Clin Pract 2018 Jan 13;135:102-110. Epub 2017 Nov 13.

Department of Internal Medicine, Charles R. Drew University, Los Angeles, CA, USA.

Aim: We performed a meta-analysis of epidemiological studies evaluating exposure to pioglitazone and the risk for bladder cancer and compared these results to the drug's effects on cardiovascular disease (CVD) and non-alcoholic steatohepatitis (NASH).

Methods: Pubmed and Embase were searched for cohort and case control studies for all years through 2016.

Results: Data from 17 papers were analyzed. In cohort studies, 822 of 357,888 pioglitazone-exposed patients (0.23%) developed bladder cancer while 7691 of 2,898,682 unexposed (0.26%) did. In case control studies, 3219 of 1,146,916 patients (0.28%) developed bladder cancer. A random effects model showed no significant association between ever vs never use or with cumulative doses of pioglitazone. However, there was a significant association with 1-2 years (HR = 1.28 [1.08-1.55]) and >2 years (HR = 1.42 [1.14-1.77]) of exposure. The numbers needed to treat for one additional case of bladder cancer ranged from 899 to 6380 while to benefit CVD and NASH, 4-256 and 2-12, respectively.

Conclusions: Given the very small prevalence of bladder cancer in diabetic patients exposed (or not) to pioglitazone (<0.3%) and the much greater beneficial effects of the drug on CVD and NASH, the use of pioglitazone should be resurrected.
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http://dx.doi.org/10.1016/j.diabres.2017.11.002DOI Listing
January 2018

Association between secondhand smoke and obesity and glucose abnormalities: data from the National Health and Nutrition Examination Survey (NHANES 1999-2010).

BMJ Open Diabetes Res Care 2017 21;5(1):e000324. Epub 2017 Mar 21.

Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Internal Medicine , Charles R. Drew University of Medicine and Science , Los Angeles, California , USA.

Objective: The objective of this study is to investigate the relationship between cotinine level-confirmed secondhand smoke (SHS) exposure and glycemic parameters and obesity.

Research Design And Methods: We examined a cohort of 6472 adults from the National Health and Nutrition Examination Surveys, 1999-2010. Serum cotinine levels and self-reported data on smoking were used to determine smoking status. The outcome variables were body mass index (BMI) and glycemic status (HbA1c), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and fasting plasma glucose (FPG). Descriptive, bivariate, and multivariate analyses were conducted.

Results: Using cotinine level-confirmed smoking status, 1794 (27.4%) of the sample were current smokers, 1681 (25.0%) were former smokers, 1158 (17.8%) were secondhand smokers, and 1839 (29.8%) were non-smokers. In a generalized linear model after controlling for potential confounding variables, secondhand smokers had higher adjusted levels of HOMA-IR, FPG, and BMI compared with non-smokers (p<0.05). Adjustment for BMI demonstrated that some, but not all, of the detrimental effects of SHS on glycemic parameters are mediated by the increased body weight of secondhand smokers.

Conclusions: We conclude that SHS is associated with obesity and worsening glycemic parameters. More studies are needed to show a causal relationship between SHS and glycemic parameters and to understand the mechanisms involved in the association.
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http://dx.doi.org/10.1136/bmjdrc-2016-000324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372029PMC
March 2017

Multiple sclerosis in pregnancy: prevalence, sociodemographic features, and obstetrical outcomes.

J Matern Fetal Neonatal Med 2018 Feb 10;31(3):382-387. Epub 2017 Apr 10.

e Oakland University, William Beaumont School of Medicine , Rochester , MI , USA.

Objective: We sought to describe the prevalence, sociodemographic features, and antenatal/peripartum outcomes of multiple sclerosis (MS) in pregnancy.

Study Design: A retrospective cohort study was performed using deliveries in California from 2001 to 2009. Cases of MS as well as other morbidities were identified via ICD-9-CM code. Logistic regression was performed to adjust for potential confounders.

Results: About 1185 out of 4,424,049 deliveries were complicated by MS. MS prevalence increased with maternal age, with Caucasians comprising a higher proportion of MS subjects. MS subjects were older and more likely to have private insurance. Women with MS were more likely to have preexisting medical conditions such as asthma, chronic hypertension, thyroid disease, or cardiac disease. However, no significant antepartum and peripartum morbidities were found to be increased in patients with MS. Urinary tract infection, cesarean delivery, and induction of labor were slightly increased in MS patients.

Conclusions: MS is a rare condition which is more likely to affect older Caucasian women of higher socioeconomic status and is associated with several preexisting medical conditions. MS, however, does not appear to pose significant increases in adverse pregnancy outcome. This suggests that pregnant patients with MS may likely experience an uneventful pregnancy.
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http://dx.doi.org/10.1080/14767058.2017.1286314DOI Listing
February 2018

Multiple sclerosis in pregnancy: prevalence, sociodemographic features, and obstetrical outcomes.

J Matern Fetal Neonatal Med 2018 Feb 10;31(3):382-387. Epub 2017 Apr 10.

e Oakland University, William Beaumont School of Medicine , Rochester , MI , USA.

Objective: We sought to describe the prevalence, sociodemographic features, and antenatal/peripartum outcomes of multiple sclerosis (MS) in pregnancy.

Study Design: A retrospective cohort study was performed using deliveries in California from 2001 to 2009. Cases of MS as well as other morbidities were identified via ICD-9-CM code. Logistic regression was performed to adjust for potential confounders.

Results: About 1185 out of 4,424,049 deliveries were complicated by MS. MS prevalence increased with maternal age, with Caucasians comprising a higher proportion of MS subjects. MS subjects were older and more likely to have private insurance. Women with MS were more likely to have preexisting medical conditions such as asthma, chronic hypertension, thyroid disease, or cardiac disease. However, no significant antepartum and peripartum morbidities were found to be increased in patients with MS. Urinary tract infection, cesarean delivery, and induction of labor were slightly increased in MS patients.

Conclusions: MS is a rare condition which is more likely to affect older Caucasian women of higher socioeconomic status and is associated with several preexisting medical conditions. MS, however, does not appear to pose significant increases in adverse pregnancy outcome. This suggests that pregnant patients with MS may likely experience an uneventful pregnancy.
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http://dx.doi.org/10.1080/14767058.2017.1286314DOI Listing
February 2018

Gender Comparison in Referrals and Treatment Completion to Residential and Outpatient Alcohol Treatment.

Subst Abuse 2016 19;10:109-116. Epub 2016 Dec 19.

Department of Family Medicine, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.

Background: Residential treatment for alcoholism is associated with high completion rates for clients, yet there appear to be gender disparities in patient referrals and treatment completion rates. We studied whether (A) gender is associated with differential patient placement to outpatient vs. residential treatment facilities and (B) completion rates differ by gender.

Methods: In this cross-sectional study, we analyzed the admission and discharge data from 185 publicly funded substance abuse treatment facilities across Los Angeles County between 2005 and 2010.

Results: Among the 33,745 studied cases, women were referred to residential treatment facilities less frequently than men (75% vs. 66%). The adjusted results derived from logistic regression models confirmed that females were more likely to be referred to outpatient treatment than to residential treatment facilities (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.05-1.26). In addition, we observed that compared to White/Caucasian patients, all other races were associated with more referral to outpatient facilities (ie, less referral to residential facilities), indicating a racial disparity on the top of the observed gender disparity. However, there was no significant link between gender and treatment completion rates (OR: 0.93, 95% CI: 0.86-1.00).

Conclusions: Women seem to have treatment completion rates comparable to men, yet they are less likely to be referred to residential treatment facilities. Hence, there still remains a gender disparity in alcoholic patient referrals. Further studies should delineate which specific therapeutic aspects and programmatic components of women-focused treatments are essential to augment positive treatment outcomes.
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http://dx.doi.org/10.4137/SART.S39943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5170882PMC
December 2016

The theory of planned behavior (TPB) and texting while driving behavior in college students.

Traffic Inj Prev 2017 01 18;18(1):56-62. Epub 2016 Apr 18.

a Charles R. Drew University of Medicine and Science , Los Angeles , California.

Objective: To examine the role of intent and other theory of planned behavior (TPB) constructs in predicting college students' willingness to text while driving (TWD).

Methods: This was a cross-sectional study. 243 male and female college students enrolled in the 2013-2014 academic year in the College of Health, Human Services & Nursing completed a survey on TWD.

Inclusion Criteria: All races and ethnicities, ≥18 years of age, cell phone owner, and licensed driver.

Results: Over 70% of the sample (n = 243) reported talking on a cell phone and sending and receiving text messages "at least a few times" while driving within the past week. However, only 27% reported being stopped by police. Of these, 22% reported being fined. Within the past 30 days, 26% reported reading or sending TWD and having to slam on the brakes to avoid hitting another car or pedestrian(s) as a result. In all, 47% of the variance in intention to send TWD was accounted for by the full TPB model. Intention, in turn, predicted willingness to TWD. Intention also mediated the relationship between perceived behavioral control and willingness to TWD.

Conclusion: Attitude was found to be the strongest predictor of intention. In addition, intention was found to mediate the relationship of willingness to TWD on perceived behavioral control. These findings highlight potential factors that could be targeted in behavioral change interventions seeking to prevent TWD.
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http://dx.doi.org/10.1080/15389588.2016.1172703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5159687PMC
January 2017

Chemopreventive Activity of MGN-3/Biobran Against Chemical Induction of Glandular Stomach Carcinogenesis in Rats and Its Apoptotic Effect in Gastric Cancer Cells.

Integr Cancer Ther 2016 12 4;15(4):NP26-NP34. Epub 2016 May 4.

Charles Drew University of Medicine and Science, Los Angeles, CA, USA.

In the current study, we investigated the chemopreventive activity of arabinoxylan rice bran, MGN-3/Biobran, against chemical induction of glandular stomach carcinogenesis in rats. Gastric cancer was induced by carcinogen methylnitronitrosoguanidine (MNNG), and rats received MNNG alone or MNNG plus Biobran (40 mg/kg body weight) for a total of 8 months. Averaged results from 2 separate readings showed that exposure to MNNG plus Biobran caused gastric dysplasia and cancer (adenocarcinoma) in 4.5/12 rats (9/24 readings, 37.5%), with 3.5/12 rats (7/24 readings, 29.2%) showing dysplasia and 1/12 rats (8.3%) developing adenocarcinoma. In contrast, in rats treated with MNNG alone, 8/10 (80%) developed dysplasia and adenocarcinoma, with 6/10 rats (60%) showing dysplasia and 2/10 rats (20%) developing adenocarcinoma. The effect of combining both agents was also associated with significant suppression of the expression of the tumor marker Ki-67 and remarkable induction in the apoptotic gastric cancer cells via mitochondrial-dependent pathway as indicated by the upregulation in p53 expression, Bax expression, downregulation in Bcl-2 expression, an increase in Bax/Bcl-2 ratio, and an activation of caspase-3. In addition, Biobran treatment induced cell-cycle arrest in the subG1 phase, where the hypodiploid cell population was markedly increased. Moreover, Biobran treatment protected rats against MNNG-induced significant decrease in lymphocyte levels. We conclude that Biobran provides protection against chemical induction of glandular stomach carcinogenesis in rats and may be useful for the treatment of human patients with gastric cancer.
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http://dx.doi.org/10.1177/1534735416642287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5739167PMC
December 2016

The Association Between Diabetes and Dementia Among Elderly Individuals: A Nationwide Inpatient Sample Analysis.

J Geriatr Psychiatry Neurol 2016 May 9;29(3):120-5. Epub 2016 Feb 9.

Department of Epidemiology, Charles R. Drew University, Los Angeles, CA, USA.

Background/aim: To date, few studies have cross-examined the relationship between diabetes mellitus (DM) and dementia nationally. There is also a lack of evidence regarding dementia subtypes and how this relationship changes among older individuals. The objective was to better delineate this relationship and influence of multiple comorbidities using a nationwide sample.

Methods: Data were obtained from the Nationwide Inpatient Sample 1998 to 2011 using appropriate International Classification of Diseases, Ninth Version codes. Descriptive and bivariate analysis was performed. Multivariate nominal logistic regression models adjusted for age, sex, race, and comorbidities explored the independent relationship between Alzheimer dementia (AD), non-Alzheimer dementia (VaD), and diabetes.

Results: 21% of the participants were diabetic patients, 3.7% had AD, and 2.2% had VaD. Diabetes prevalence in AD, VaD, and no dementia groups were 20.6%, 24.3%, and 26.2%, respectively. In the unadjusted model, those with DM had lower odds of AD (odds ratio [OR] 0.73; 95% confidence interval [CI] 0.72-0.74) and VaD (OR 0.91, 95% CI 0.89-0.92). Adjusting for age, sex, race, and comorbidities, diabetic patients had significantly higher odds of VaD (OR = 1.10, 95% CI 1.08-1.11) and lower odds of AD (OR 0.87, 95% CI 0.86-0.88). Inclusion of interaction terms (age, race/ethnicity, depression, stroke, and hypertension) made the relationship between diabetes and VaD not significant (OR 1.002, 95% CI 0.97-1.03), but the relationship of DM with AD remained significant (OR 0.57, 95% CI 0.56-0.58; P < .05).

Conclusion: Patients with a diagnosis of diabetes mellitus had lower odds of having AD. Age, race/ethnicity, depression, stroke, and hypertension modified the relationship between DM and both VaD and AD. Further exploration of the relationship between DM and AD is warranted.
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http://dx.doi.org/10.1177/0891988715627016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102621PMC
May 2016

Hydroferrate fluid, MRN-100, provides protection against chemical-induced gastric and esophageal cancer in Wistar rats.

Int J Biol Sci 2015 28;11(3):295-303. Epub 2015 Jan 28.

5. Department of Pathology, Charles Drew University of Medicine and Science, 1731 E. 120th Street, Los Angeles, CA 90059, USA.

In the current study, we examined the protective effect of hydroferrate fluid MRN-100 against the carcinogen methylnitronitrosoguanidine (MNNG)-induced gastric and esophageal cancer in rats. MRN-100 is an iron-based compound composed of bivalent and trivalent ferrates. At 33 weeks post treatment with MNNG, rats were killed and examined for the histopathology of esophagus and stomach; liver, spleen, and total body weight; and antioxidant levels in the blood and stomach tissues. Results showed that 17/20 (85%) gastroesophageal tissues from carcinogen MNNG-treated rats developed dysplasia and cancer, as compared to 8/20 (40%) rats treated with MNNG plus MRN-100. In addition, MRN-100 exerted an antioxidant effect in both the blood and stomach tissues by increasing levels of GSH, antioxidant enzymes SOD, CAT, and GPx, and total antioxidant capacity (TAC) level. This was accompanied by a reduction in the total free-radical and malondialdehyde levels. Furthermore, MRN-100 protected against body and organ weight loss. Thus, MRN-100 exhibited significant cancer chemopreventive activity by protecting tissues against oxidative damage in rats, which may suggest its effectiveness as an adjuvant for the treatment of gastric/esophageal carcinoma.
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http://dx.doi.org/10.7150/ijbs.10586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4323369PMC
November 2015

Amniotic fluid embolism: antepartum, intrapartum and demographic factors.

J Matern Fetal Neonatal Med 2015 May 30;28(7):793-8. Epub 2014 Jun 30.

Department of Obstetrics and Gynecology, University of California, Irvine Medical Center , Orange, CA , USA .

Objective: To describe the incidence, antepartum, intrapartum and postpartum risk factors, and mortality rate of amniotic fluid embolism (AFE).

Methods: We used 2001-2007 California health discharge data to identify cases of AFE by ICD-9 codes.

Results: Of 3,556,567 deliveries during the time period, we identified 182 cases of AFE, resulting in a population incidence of 5.1 in 100,000. Twenty-four of the cases resulted in death, giving a case fatality rate of 13.2%. Non-Hispanic blacks had a higher than 2-fold odds of developing AFE. AFE increased significantly with maternal age, most significantly after age 39. Cardiac disease had a nearly 70-fold higher association with AFE, cerebrovascular disorders had a 25-fold higher association, while conditions such as eclampsia, renal disease, placenta previa and polyhydramnios had nearly 7- to 13-fold higher associations. Classical cesarean delivery, abruption placentae, dilation and curettage, and amnioinfusion were all procedures highly associated with AFE.

Conclusion: Several antepartum and peripartum conditions and procedures are associated with significantly higher risks of amniotic fluid embolism. This information may contribute to a better understanding of the pathophysiology of AFE and potentially help identify those at the highest risk of developing this morbid condition.
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http://dx.doi.org/10.3109/14767058.2014.932766DOI Listing
May 2015

Epidemiological ramifications of diagnosing diabetes with HbA1c levels.

J Diabetes Complications 2014 Jul-Aug;28(4):464-9. Epub 2014 Apr 2.

Charles R. Drew University, Los Angeles, California.

Aims: To compare the prevalence of diabetes by history and using the fasting plasma glucose (FPG) criterion alone, the HbA1c criterion alone or either one in those not known to have diabetes.

Methods: Analysis of NHANES population ≥20years old from 1999 through 2010.

Results: In those diagnosed by laboratory tests, 86% met the FPG criterion and 53% met the HbA1c criterion. The prevalence of diabetes (history or laboratory test) was significantly increased when the FPG criterion was used compared with the HbA1c criterion in the entire (11.5% vs 10.5%, P=0.018) and Caucasian (10.6% vs 9.2%, P=0.022) populations. In contrast, there were no significant differences in the prevalence when only the FPG criterion was used compared with only the HbA1c criterion in Hispanics (12.9% vs 12.1% P=0.386) and African Americans (14.5 vs 14.3%, P=0.960). Using history and either criterion in those not known to have it, diabetes increased by 61% in this 12year period in adults ≥20years old.

Conclusions: Using the FPG rather than the HbA1c criterion to diagnose diabetes in those without a history significantly increased the total prevalence of diabetes in Caucasians but not in African Americans or Hispanics.
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http://dx.doi.org/10.1016/j.jdiacomp.2014.03.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287398PMC
February 2015

Temporal trends and morbidities of vacuum, forceps, and combined use of both.

J Matern Fetal Neonatal Med 2014 Dec 9;27(18):1886-91. Epub 2014 Apr 9.

Department of Obstetrics and Gynecology, University of California, Irvine Medical Center , Orange, CA , USA .

Objective: To assess trends over time of operative vaginal delivery and compare delivery-related morbidity between vacuum delivery, forceps delivery, or combined use of both in California.

Methods: California ICD-9 discharge data from 2001 to 2007 were used to identify cases of forceps and vacuum delivery.

Results: There was a decline in all operative delivery types (9.0% in 2001 to 7.6% in 2007), with the decline in the use of forceps most pronounced (7.26/1000 deliveries in 2001 to 3.85/1000 in 2007). Higher rates of third/fourth degree lacerations, postpartum hemorrhage, manual extraction of placenta, pelvic hematoma requiring evacuation, cervical laceration repair, and thromboembolic events were noted in forceps compared to vacuum deliveries. When both instruments were used, rates of third/fourth degree lacerations and postpartum hemorrhage were increased. Operative delivery failure was highest in combined use compared to forceps or vacuum alone.

Conclusion: The incidence of operative vaginal delivery in California is declining, with decreasing use of forceps most notable. Several maternal morbidities are increased in forceps and combined deliveries compared to vacuum deliveries. There is a significantly higher risk of failure when two operative delivery methods are employed. These findings may be contributing to the declining willingness of providers to perform operative vaginal delivery.
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http://dx.doi.org/10.3109/14767058.2014.904282DOI Listing
December 2014

Racial and ethnic disparities in the incidence and mortality from septic shock and respiratory failure among elective neurosurgery patients.

Neurol Res 2014 Oct 12;36(10):857-65. Epub 2014 Mar 12.

Objectives: Septic shock (SS) and respiratory failure (RF) are serious complications after neurosurgical procedures. Research is limited in studying racial/ethnic disparities in incidence and mortality of SS and RF. The study aimed to determine the racial variation in incidence and mortality from SS and RF among elective neurosurgical patients in California.

Methods: Data were analyzed from 206 902 admissions of elective neurosurgical patients in California from 2001 to 2009. Variables included race/ethnicity, age, gender, insurance, procedure site, and co-morbidities. We used descriptive, bivariate, and multivariate statistics in SAS v9·3.

Results: Septic shock incidence was 0·30/1000/year and case fatality (CF) was 47·7%. Respiratory failure incidence was 4·7/1000/year and CF was 26·2%. Blacks had higher SS and RF (0·6 and 7·9%, respectively) compared to Whites (0·2 and 4·3%, respectively) (Chi-square, P < 0·01). In the adjusted logistic regression model, Blacks had higher odds of SS (Adjusted Odds Ratio [AOR]  =  1·56, 95% CI  =  1·16-2·10) and RF (AOR  =  1·22, 95% CI  =  1·11-1·33) relative to Whites. Although, Blacks had higher mortality from SS (58·9%) and RF (30·1%) compared to Whites (45·2 and 26·4%, respectively; P < 0·05), the AORs were not statistically significant (P > 0·05).

Discussion: Blacks had a higher incidence of SS and RF. A higher percentage of black patients died from SS-related mortality, followed by Hispanics, than other groups. The attenuation of differences after statistical adjustment suggests the excess mortality may be due to age, site of the procedures, and having neoplastic disease. Our findings support the need for prospective studies to assess specific pre-operative interventions driven by age and co-morbidities that might reduce the risk of complications after neurosurgical procedures.
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http://dx.doi.org/10.1179/1743132814Y.0000000343DOI Listing
October 2014

Association of race/ethnicity, inflammation, and albuminuria in patients with diabetes and early chronic kidney disease.

Diabetes Care 2014 Apr 18;37(4):1060-8. Epub 2014 Feb 18.

Corresponding author: Satyesh K. Sinha,

OBJECTIVE African Americans (AAs) and Hispanics have higher diabetes and end-stage renal disease but similar or lower early chronic kidney disease (CKD) compared with whites. Inflammation plays a critical role in the pathogenesis of diabetes-related CKD. We postulated that in contrast to the general population, AAs and Hispanics have a higher prevalence of early diabetic CKD and systemic inflammatory markers compared with whites. RESEARCH DESIGN AND METHODS We analyzed the National Health and Nutrition Examination Survey 1999-2008 of 2,310 diabetic patients aged ≥20 years with fasting plasma glucose (FPG) ≥126 mg/dL. We performed multiple linear regression among patients with early CKD (urinary albumin excretion [UAE] ≥30 μg/mL and estimated glomerular filtration rate ≥60 mL/min/1.73 m(2)) to test the relationship between UAE and C-reactive protein (CRP) by race/ethnicity, adjusting for demographics, diabetes duration, FPG, hemoglobin A1c, uric acid, white blood cell count, medication use, cardiovascular disease, and related parameters. RESULTS In patients with diabetes, the prevalence of early CKD was greater among Hispanics and AAs than whites (P < 0.0001). AAs had higher adjusted odds ratio (AOR) for CRP ≥0.2 mg/dL (AOR 1.81 [95% CI 1.19-2.78]), and Hispanics had higher AOR for UAE ≥30 μg/mL (AOR 1.65 [1.07-2.54]). In a regression model adjusted for confounding variables, there was a significant association between UAE and CRP in the mid-CRP tertile (CRP 0.20-0.56 mg/dL, P = 0.001) and highest CRP tertile (CRP ≥0.57 mg/dL, P = 0.01) for Hispanics, but only in the mid-CRP tertile (P = 0.04) for AAs, compared with whites. CONCLUSIONS AAs and Hispanics with diabetes have a higher prevalence of early CKD compared with whites, which is significantly associated with UAE and/or CRP.
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http://dx.doi.org/10.2337/dc13-0013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069363PMC
April 2014

Traumatic brain injury related hospitalization and mortality in California.

Biomed Res Int 2013 13;2013:143092. Epub 2013 Nov 13.

Charles R Drew University of Medicine & Science, David Geffen School of Medicine at UCLA, 1731 East 120th Street, Los Angeles, CA 90059, USA.

Objective: The aim of this study is to describe the traumatic brain injury (TBI) population and causes and identify factors associated with TBI hospitalizations and mortality in California.

Methods: This is a cross-sectional study of 61,188 patients with TBI from the California Hospital Discharge Data 2001 to 2009. We used descriptive, bivariate, and multivariate analyses in SAS version 9.3.

Results: TBI-related hospitalizations decreased by 14% and mortality increased by 19% from 2001 to 2009. The highest percentages of TBI hospitalizations were due to other causes (38.4%), falls (31.2%), being of age ≥75 years old (37.2%), being a males (58.9%), and being of Medicare patients (44%). TBIs due to falls were found in those age ≤4 years old (53.5%), ≥75 years old (44.0%), and females (37.2%). TBIs due to assaults were more frequent in Blacks (29.0%). TBIs due to motor vehicle accidents were more frequent in 15-19 and 20-24 age groups (48.7% and 48.6%, resp.) and among Hispanics (27.8%). Higher odds of mortality were found among motor vehicle accident category (adjusted odds ratio (AOR): 1.27, 95% CI: 1.14-1.41); males (AOR: 1.36, 95% CI: 1.27-1.46); and the ≥75-year-old group (AOR: 6.4, 95% CI: 4.9-8.4).

Conclusions: Our findings suggest a decrease in TBI-related hospitalizations but an increase in TBI-related mortality during the study period. The majority of TBI-related hospitalizations was due to other causes and falls and was more frequent in the older, male, and Medicare populations. The higher likelihood of TBI-related mortalities was found among elderly male ≥75 years old who had motor vehicle accidents. Our data can inform practitioners, prevention planners, educators, service sectors, and policy makers who aim to reduce the burden of TBI in the community. Implications for interventions are discussed.
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http://dx.doi.org/10.1155/2013/143092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845866PMC
July 2014

Pre-gestational versus gestational diabetes: a population based study on clinical and demographic differences.

J Diabetes Complications 2014 Jan-Feb;28(1):29-34. Epub 2013 Oct 4.

David Geffen School of Medicine, Los Angeles, CA.

Aims: To assess the clinical and demographic differences in patients with pre-gestational diabetes mellitus (PGDM) compared to those with gestational diabetes (GDM).

Methods: Using the 2001-2007 California Health Discharge Database, we identified 22,331 cases of PGDM and 147,097 cases of GDM via ICD-9-CM codes after excluding cases which were missing race or age data or with extremes of age. Data analyzed included demographics, pre-existing medical conditions, antepartum complications, and intrapartum complications. Logistic regression was used to adjust for potential confounders.

Results: Both PGDM and GDM incidences increased during the study period. Advancing age was associated with increased prevalence of both diseases. Although Asians were found to have the highest prevalence of GDM, they, along with Caucasians, were found have the lowest prevalence of PGDM. Conditions with increased frequency in PGDM versus GDM included chronic hypertension, renal disease, thyroid dysfunction, fetal CNS malformation, fetal demise, pyelonephritis, and eclampsia. Subjects with PGDM were more likely than those with GDM to have a shoulder dystocia, failed induction of labor, or undergo cesarean delivery.

Conclusions: We have demonstrated clinical morbidities and demographic factors which differ in patients with PGDM compared to patients with GDM. Our findings suggest PGDM to be associated with significantly higher morbidity when compared to GDM. Our findings also suggest that races with the highest tendency for GDM during pregnancy may not necessarily have the highest tendency for PGDM outside of pregnancy.
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http://dx.doi.org/10.1016/j.jdiacomp.2013.08.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887473PMC
August 2014

Clinical morbidities, trends, and demographics of eclampsia: a population-based study.

Am J Obstet Gynecol 2013 Sep 30;209(3):229.e1-7. Epub 2013 May 30.

Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA, USA.

Objective: We sought to identify trends, demographics, and prepregnancy and peripartum morbidities of eclampsia in California.

Study Design: We identified cases of eclampsia by International Classification of Diseases, Ninth Revision code using California health discharge data from 2001 through 2007. Cases with missing race/ethnicity as well as age <15 years or >55 years were excluded. Among the remaining cases, patients with eclampsia (n = 1888) were compared against those without (n = 2,768,983). Adjustments were performed for potential confounding variables using logistic regression. Significance was set at P < .05.

Results: The incidence of eclampsia decreased over time, from 8.0 cases per 10,000 deliveries in 2001, to 5.6 cases per 10,000 deliveries in 2007 (P < .001). There was a bimodal distribution in age-related risk, with the highest risks at the extremes of age. Non-Hispanic blacks were associated with the highest risk of eclampsia while Asians had the lowest risk. Several antepartum morbidities had increased associations with eclampsia, including preexisting cardiac disease (adjusted odds ratio [OR], 6.84; 95% confidence interval [CI], 5.40-8.66), lupus erythematosus (adjusted OR, 3.68; 95% CI, 1.53-8.86), and twin gestations (adjusted OR, 3.28; 95% CI, 2.70-3.99). Peripartum complications increased in eclampsia included cerebrovascular hemorrhage/disorders (adjusted OR, 112.15; 95% CI, 77.47-162.35), peripartum cardiomyopathy (adjusted OR, 12.88; 95% CI, 6.08-27.25), amniotic fluid embolism (adjusted OR, 11.94; 95% CI, 3.63-39.21), and venous thromboembolism (adjusted OR, 10.71; 95% CI, 5.14-22.32).

Conclusion: This large population database confirms that there is a decline in eclampsia over time. However, there are extremely morbid complications associated with eclampsia, emphasizing the need for its close monitoring and prevention.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886372PMC
http://dx.doi.org/10.1016/j.ajog.2013.05.050DOI Listing
September 2013

Protective effect of hydroferrate fluid, MRN-100, against lethality and hematopoietic tissue damage in γ-radiated Nile tilapia, Oreochromis niloticus.

J Radiat Res 2013 Sep 14;54(5):852-62. Epub 2013 Apr 14.

Departments of Otolaryngology, Charles Drew University of Medicine and Science, 1621 East, 120th Street, Los Angeles, California 90059.

Hydroferrate fluid, MRN-100, an iron-based compound derived from bivalent and trivalent ferrates, is a potent antioxidant compound. Therefore, we examined the protective effect of MRN-100 against γ-radiation-induced lethality and damage to hematopoietic tissues in fish. A total of 216 Nile tilapia fish (Oreochromis niloticus) were randomly divided into four groups. Group 1 served as a control that was administered no radiation and no MRN-100 treatment. Group 2 was exposed only to γ-radiation (15 Gy). Groups 3 and 4 were pre-treated with MRN-100 at doses of either 1 ml/l or 3 ml/l in water for 1 week, and subsequently exposed to radiation while continuing to receive MRN-100 for 27 days. The survival rate was measured, and biochemical and histopathological analyses of hematopoietic tissues were performed for the different treatment groups at 1 and 4 weeks post-radiation. Exposure to radiation reduced the survival rate to 27.7%, while treatment with MRN-100 maintained the survival rate at 87.2%. In addition, fish exposed to γ-radiation for 1 week showed a significant decrease in the total number of white blood cells (WBCs) and red blood cells (RBCs) series. However, treatment with MRN-100 protected the total WBC count and the RBCs series when compared with irradiated fish. Furthermore, significant histological lesions were observed in the hepatopancreas, spleen and gills of irradiated fish. However, treatment with MRN-100 protected the histopathology of various organs. We conclude that MRN-100 is a radioprotective agent in fish and may be useful as an adjuvant treatment to counteract the adverse side effects associated with radiation exposure.
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http://dx.doi.org/10.1093/jrr/rrt029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766301PMC
September 2013