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Vision Impairment and Adverse Health Conditions in Congolese Older People: A Population-Based Study.

Gerontology 2021 Jul 27:1-10. Epub 2021 Jul 27.

INSERM, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, University of Limoges, Limoges, France.

Introduction: In sub-Saharan Africa, many older people experience vision impairment (VI) and its adverse health outcomes. In this study, we examined separately the association between VI and each adverse health conditions (cognitive disorders, vision-related quality of life [VRQoL], and daily functioning interference [DFI]) among Congolese older people. We also explored whether VI had a significant effect on VRQoL components in our population. Read More

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Predictors of having naloxone in urban and rural Oregon findings from NHBS and the OR-HOPE study.

Drug Alcohol Depend 2021 Jul 21;227:108912. Epub 2021 Jul 21.

Public Health Division, Oregon Health Authority, 800 NE Oregon Street, Portland, OR, 97232, USA; Department of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. Electronic address:

Purpose: Naloxone is an opioid antagonist that can be effectively administered by bystanders to prevent overdose. We determined the proportion of people who had naloxone and identified predictors of naloxone ownership among two samples of people who inject drugs (PWID) who use opioids in Portland and rural Western Oregon.

Basic Procedures: We used data from participants in Portland's National HIV Behavioral Surveillance (NHBS, N = 477) and the Oregon HIV/Hepatitis and Opioid Prevention and Engagement Study (OR-HOPE, N = 133). Read More

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Effect of physical activity and BMI SDS on bone metabolism in children and adolescents.

Bone 2021 Jul 24:116131. Epub 2021 Jul 24.

Department of Pediatric Surgery, University Hospital Leipzig, Leipzig, Germany. Electronic address:

Objective: Children with obesity are known to have reduced bone density and are at a higher risk for fractures. This may be caused by decreased physical activity or a metabolic phenomenon. In this study, we evaluated associations of physical activity with bone metabolism in children and adolescents with and without obesity. Read More

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Effects of a remote, YouTube-delivered exercise intervention on young adults' physical activity, sedentary behavior, and sleep during the COVID-19 pandemic: Randomized controlled trial.

J Sport Health Sci 2021 Jul 24. Epub 2021 Jul 24.

School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA. Electronic address:

Background: Public health guidelines have called for innovative and flexible physical activity (PA) intervention strategies to promote PA and health amid the COVID-19 pandemic. Therefore, this study's purpose was to examine the effects of a home-based, YouTube-delivered PA intervention grounded in self-determination theory (SDT) on young adults' free-living PA, sedentary behavior (SB), and sleep quality (NCT04499547).

Methods: Sixty-four young adults (48 females; age: 22. Read More

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Temporal Trends and Risk of Small for Gestational Age (SGA) Infants among Asian American Mothers by Ethnicity.

Ann Epidemiol 2021 Jul 24. Epub 2021 Jul 24.

Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas USA; Family and Community Medicine, Baylor College of Medicine, Houston, Texas USA.

Purpose: To examine the temporal trends and risk of small for gestational age (SGA) phenotypes across Asian American ethnic groups.

Methods: We conducted a population-based retrospective study using the 1992-2018 natality data files obtained from the National Vital Statistics System. Joinpoint regression modeling was employed to calculate the average annual percentage change in SGA birth rates among Asian American sub-groups and NH-White women. Read More

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Mid- to late-life inflammation and risk of cardiac dysfunction, HFpEF, and HFrEF in late-life.

J Card Fail 2021 Jul 24. Epub 2021 Jul 24.

Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA. Electronic address:

Background: Epidemiologic data supporting the association of accumulated inflammation from mid-to late-life with late life risk of cardiac dysfunction and heart failure (HF) is limited.

Methods And Results: Among 4,011 participants in the ARIC study free of prevalent cardiovascular disease at study Visit 5, accumulated inflammation was defined as time-averaged hsCRP over three visits spanning 1990-2013. Associations with LV function at Visit 5 and with incident adjudicated HF post-Visit 5 were assessed using linear and Cox regression adjusting for demographics and comorbidities. Read More

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The 5-year course of neck pain among natural disaster survivors: The association of prior neck pain with new episodes of neck pain.

Pain Med 2021 Jul 27. Epub 2021 Jul 27.

Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.

Objective: Neck pain is a common health problem among both the general population and natural disaster survivors. However, the long-term course of neck pain has rarely been reported. The aim of this study was to elucidate the 5-year course of neck pain among survivors of the Great East Japan Earthquake (GEJE) by assessing the association of neck pain 2 and 4 years after the disaster with that at 7 years. Read More

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Geographic, gender and seasonal variation of diabetes: a nationwide study among 1.4 million participants.

J Clin Endocrinol Metab 2021 Jul 27. Epub 2021 Jul 27.

School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.

Background: China experienced a rapid increase in the prevalence of diabetes.

Objectives: To assess the prevalence of diabetes among Chinese adults who attend preventive physical examination, and analyzed geographical and gender difference in seasonal variation of fasting blood glucose (FBG).

Methods: The study used data from 1,390,088 participants attending preventive health examination at 430 health screening centers in 220 cities. Read More

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Lower serum 25(OH)D levels associated with higher risk of COVID-19 infection in U.S. Black women.

PLoS One 2021 27;16(7):e0255132. Epub 2021 Jul 27.

Slone Epidemiology Center at Boston University, Boston, Massachusetts, United States of America.

Objective: Limited evidence suggests that higher levels of serum vitamin D (25(OH)D) protect against SARS-CoV-2 virus (COVID-19) infection. Black women commonly experience 25(OH)D insufficiency and are overrepresented among COVID-19 cases. We conducted a prospective analysis of serum 25(OH)D levels in relation to COVID-19 infection among participants in the Black Women's Health Study. Read More

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Cost Analysis of Volar Plate Fixation Versus Plaster Cast Immobilization for Intra-Articular Distal Radial Fractures.

J Bone Joint Surg Am 2021 Jul 27. Epub 2021 Jul 27.

Department of Trauma and Hand Surgery, Maasstad Hospital, Rotterdam, the Netherlands.

Background: The aim of this study was to compare the cost-effectiveness and cost-utility between plaster cast immobilization and volar plate fixation for acceptably reduced intra-articular distal radial fractures.

Methods: A cost-effectiveness analysis was conducted as part of a randomized controlled trial comparing operative (volar plate fixation) with nonoperative (plaster cast immobilization) treatment in patients between 18 and 75 years old with an acceptably reduced intra-articular distal radial fracture. Health-care utilization and use of resources per patient were documented prospectively and included direct medical costs, direct non-medical costs, and indirect costs. Read More

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Epidemiology, Outcomes, and Trends of Patients With Sepsis and Opioid-Related Hospitalizations in U.S. Hospitals.

Crit Care Med 2021 Jun 23. Epub 2021 Jun 23.

Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA.

Objectives: Widespread use and misuse of prescription and illicit opioids have exposed millions to health risks including serious infectious complications. Little is known, however, about the association between opioid use and sepsis.

Design: Retrospective cohort study. Read More

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Care for food-insecure enrollees in Medicare Advantage vs traditional Medicare.

Am J Manag Care 2021 Jul 1;27(7):e234-e241. Epub 2021 Jul 1.

Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Nesbitt Hall, 3215 Market St, Philadelphia, PA 19104. Email:

Objectives: To examine whether enrollment in Medicare Advantage (MA) and fee-for-service traditional Medicare (TM) is differential by food insecurity and then examine differences in health care utilization, financial burden, care satisfaction, and health status between food-insecure enrollees in MA and TM and between food-secure enrollees in MA and TM.

Study Design: We employed a retrospective cohort study design. Using the 2015-2016 Medicare Current Beneficiary Survey, we identified the following 4 mutually exclusive groups: food-insecure enrollees in MA, food-insecure enrollees in TM, food-secure enrollees in MA, and food-secure enrollees in TM. Read More

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Variation in spending associated with primary care practices.

Am J Manag Care 2021 Jul;27(7):297-300

Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Ste 207, Boston, MA 02115. Email:

Objectives: To measure variation in spending and inpatient prices associated with the primary care physician (PCP) practice to which patients are attributed.

Study Design: Cross-sectional analysis of claims data.

Methods: We used random effect models to estimate case mix-adjusted spending across large PCP practices within 3-digit zip codes. Read More

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Large self-insured employers lack power to effectively negotiate hospital prices.

Am J Manag Care 2021 Jul;27(7):290-296

Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Rm 406, Baltimore, MD 21205. Email:

Objectives: Self-insured employers cover more people than Medicare, Medicaid, or direct purchasers of private insurance.This study examined the ability of self-insured employers to negotiate hospital prices and the relationship between hospital prices and employer market power in the United States.

Study Design: Repeated cross-section analysis of commercial claims. Read More

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ACA Medicaid expansion association with racial disparity reductions in timely cancer treatment.

Am J Manag Care 2021 Jul;27(7):274-281

Flatiron Health, Inc, 233 Spring St, Fifth Fl, New York, NY 10025. Email:

Objectives: Racial disparities in cancer care and outcomes remain a societal challenge. Medicaid expansion through the Affordable Care Act was intended to improve health care access and equity. This study aimed to assess whether state Medicaid expansions were associated with a reduction in racial disparities in timely treatment among patients diagnosed with advanced cancer. Read More

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Self-concept and body image of people living with lupus: A systematic review.

Int J Rheum Dis 2021 Jul 27. Epub 2021 Jul 27.

Department Obstetrics and Gynecology, School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil.

Aim: To summarize existing evidence regarding body image in patients with systemic lupus erythematosus, with the following considerations: (a) the perceptions patients have of their body changes; (b) how patients cope with changes in their body; (c) and what their perceptions are of body changes.

Method: A systematic review of literature integrating quantitative and qualitative studies. We searched databases (PubMed, CINAHL, Embase, SCOPUS, the Web of Science, Medline, Medline Complete, and Academic Search Premier) and publications from 2010 to 2020 with "Systemic Lupus Erythematosus" AND "Self-Concept" OR "Body Image" AND "Woman" as medical subheading terms. Read More

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Tobacco smoking and severity of COVID-19: Experience from a hospital-based prospective cohort study in Lyon-France.

J Med Virol 2021 Jul 27. Epub 2021 Jul 27.

Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.

Introduction: Information gathered so far from published studies attest the existence of a complex relationship between tobacco smoking and the severity of COVID-19. We investigated the association between smoking habits and the severity of COVID-19 in patients hospitalized in university-affiliated hospitals in Lyon-France.

Methods: Baseline socio-demographic, clinical and biological characteristics of adult COVID-19 hospitalized patients presenting from the community were prospectively collected and analysed. Read More

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Oral hygiene and health-related quality of life in institutionalized older people.

Eur Geriatr Med 2021 Jul 27. Epub 2021 Jul 27.

Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.

Purpose: We evaluated the level of oral hygiene and its association with oral health status and need for oral treatment among older residents in long-term care facilities. In addition, the association between oral hygiene level and health-related quality of life (HRQoL) was explored.

Methods: This cross-sectional study assessed 231 dentate residents in long-term care facilities (71% female, mean age 81 years, 70% had dementia). Read More

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Influencing factors for the decline of limb muscle strength and the association with all-cause mortality: evidence from a nationwide population-based cohort study.

Aging Clin Exp Res 2021 Jul 27. Epub 2021 Jul 27.

Arthritis Clinic & Research Center, Peking University People's Hospital, Peking University, Beijing, 100044, China.

Background: The decline of muscle strength, a typical characteristic of sarcopenia, greatly affects aging-related health outcomes; however, prospective data on influencing factors and mortality in the Chinese population are relatively sparse.

Aims: We investigated the influencing factors for the declined limb muscle strength and the association with all-cause mortality among the elderly Chinese individuals aged ≥ 65 years in a large long-term prospective cohort study.

Methods: We used data from the China Health and Retirement Longitudinal Study (CHARLS). Read More

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Association between rs3088440 (G > A) polymorphism at 9p21.3 locus with the occurrence and severity of coronary artery disease in an Iranian population.

Mol Biol Rep 2021 Jul 27. Epub 2021 Jul 27.

Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Several genome-wide association studies showed that a series of genetic variants located at the chromosome 9p21 locus are strongly associated with coronary artery disease (CAD).

Rationale And Purpose Of The Study: In the present study, the relationship of rs3088440 (G > A) in cyclin-dependent kinase inhibitor 2A (CDKN2A) gene site with the presence of coronary artery disease (CAD) and its severity was evaluated in an Iranian population.

Methods And Results: The presence of rs3088440 (G > A) genotypes was assessed by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) technique in 324 CAD patients and 148 normal controls. Read More

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Electronic nicotine product cessation and cigarette smoking: analysis of waves 3 and 4 from the PATH study.

Nicotine Tob Res 2021 Jul 27. Epub 2021 Jul 27.

Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.

Introduction: Identifying predictors of electronic nicotine product (ENP) cessation can inform ENP cessation interventions. High rates of co-occurring ENP and cigarette (dual) use and transitions between these products underscore the importance of considering cigarette smoking status when assessing and addressing ENP cessation.

Methods: We analyzed waves 3 (W3) and 4 (W4) of the Population Assessment of Tobacco and Health (PATH) study to identify (i) W3 socio-demographics, tobacco and ENP use characteristics, and psychosocial correlates of W3 cigarette smoking status (non-smoker, former and current) among W3 adult ENP users, and (ii) W3 predictors of W4 combined ENP and cigarette smoking abstinence relative to use of one or both products. Read More

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Higher Habitual Flavonoid Intakes Are Associated With A Lower Incidence Of Diabetes.

J Nutr 2021 Jul 27. Epub 2021 Jul 27.

Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.

Background: Higher flavonoid intakes are hypothesised to confer protection against type 2 diabetes mellitus.

Objective: We aimed to 1) investigate associations between flavonoid intakes and diabetes, 2) examine the mediating impact of body fat, and 3) identify subpopulations that may receive the greatest benefit from higher flavonoid intakes in participants of the Danish Diet, Cancer, and Health Study followed-up for 23 years.

Design: Cross-sectional associations between baseline flavonoid intake, estimated using food frequency questionnaires and the Phenol Explorer database, and body fat estimated by bioelectrical impedance, were assessed using multivariable-adjusted linear regression models. Read More

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Cost-effectiveness of Dapagliflozin for the Treatment of Heart Failure With Reduced Ejection Fraction.

JAMA Netw Open 2021 Jul 1;4(7):e2114501. Epub 2021 Jul 1.

Harvard Medical School, Boston, Massachusetts.

Importance: Heart failure with reduced ejection fraction produces substantial morbidity, mortality, and health care costs. Dapagliflozin is the first sodium-glucose cotransporter 2 inhibitor approved for the treatment of heart failure with reduced ejection fraction.

Objective: To examine the cost-effectiveness of adding dapagliflozin to guideline-directed medical therapy for heart failure with reduced ejection fraction in patients with or without diabetes. Read More

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Iodine Status of Canadian Children, Adolescents and Women of Childbearing Age.

J Nutr 2021 Jul 27. Epub 2021 Jul 27.

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Background: Adequate iodine intake is important for children and women of childbearing age because iodine is vital for fetal brain development and early life.

Objective: Iodine status of children (n = 1875), adolescents (n = 557) and women of childbearing age (n = 567) was assessed using urinary iodine concentrations (UIC) from duplicate spot samples collected in the Canadian Health Measures Survey, cycle 5 (2016 - 2017).

Methods: Daily iodine intakes were estimated from urinary iodine and creatinine concentrations using a formula based on iodine absorption and predicted 24-h creatinine excretion. Read More

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Association Between Mental Health Disorders and Mortality Among Patients With COVID-19 in 7 Countries: A Systematic Review and Meta-analysis.

JAMA Psychiatry 2021 Jul 27. Epub 2021 Jul 27.

Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, Marseille, France.

Importance: Heterogeneous evidence exists for the association between COVID-19 and the clinical outcomes of patients with mental health disorders. It remains unknown whether patients with COVID-19 and mental health disorders are at increased risk of mortality and should thus be targeted as a high-risk population for severe forms of COVID-19.

Objective: To determine whether patients with mental health disorders were at increased risk of COVID-19 mortality compared with patients without mental health disorders. Read More

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Effect of a Hospital and Postdischarge Quality Improvement Intervention on Clinical Outcomes and Quality of Care for Patients With Heart Failure With Reduced Ejection Fraction: The CONNECT-HF Randomized Clinical Trial.

JAMA 2021 Jul;326(4):314-323

Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

Importance: Adoption of guideline-directed medical therapy for patients with heart failure is variable. Interventions to improve guideline-directed medical therapy have failed to consistently achieve target metrics, and limited data exist to inform efforts to improve heart failure quality of care.

Objective: To evaluate the effect of a hospital and postdischarge quality improvement intervention compared with usual care on heart failure outcomes and care. Read More

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Hormone therapy formulation, dose, route of delivery, and risk of hypertension: findings from the Women's Health Initiative Observational Study (WHI-OS).

Menopause 2021 Jul 26. Epub 2021 Jul 26.

Department of Obstetrics and Gynecology, Biostatistics and Epidemiology, Family and Preventive Medicine University of Oklahoma Health Sciences Center, Oklahoma City, OK Statistical Research Associate, Fred Hutchinson Cancer Research Center, Seattle, WA Department of Medicine, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, CA Department of Family Medicine, University of California San Diego School of Medicine, La Jolla, CA The North American Menopause Society Emeritus, Cleveland, OH Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA.

Objective: Using data from the Women's Health Initiative Observational Study (WHI-OS), to determine the role of estrogen formulation, dose, route of delivery, and its combination with different progestogens on the risk for hypertension in the WHI-OS.

Methods: After excluding women with diagnosed hypertension, receiving antihypertensive medication, presenting with elevated blood pressure ( ≥ 140/90), and those not taking menopausal hormone therapy at baseline, 19,986 women remained eligible for the analyses. Using hierarchal modeling, proportional hazard rate calculation, and linear and logistic regression analyses, we evaluated incident treated hypertension and mean systolic and diastolic blood pressure changes at 3 years. Read More

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Physical activity domains are differently related with quality of life in breast cancer survivors: a cross-sectional study.

Menopause 2021 Jul 26. Epub 2021 Jul 26.

Department of Physiotherapy, School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, SP, Brazil Department of Physical Education, School of Technology and Sciences, São Paulo State University (Unesp), Presidente Prudente, SP, Brazil Department of Medicine, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil.

Objectives: Treatments for breast cancer (BC) can lead to physical and mental impairments which may affect quality of life (QoL). Physical activity (PA) is highly recommended for this population due to its protective effect against BC relapse and its ability to reduce the health impact of treatment. However, it is not clear whether the different domains of PA are associated with better QoL of BC survivors. Read More

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A Combination of Healthy Lifestyle Behaviors Reduces Risk of Incident Systemic Lupus Erythematosus.

Arthritis Rheumatol 2021 Jul 27. Epub 2021 Jul 27.

Division of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Objective: While the association between individual factors related to lifestyle and the risk of SLE has been previously evaluated, it is unclear how the combination of these factors might affect the risk of incident SLE. We prospectively evaluated whether a combination of healthy lifestyle factors is associated with lower risk of incident SLE and its subtypes (dsDNA positive and negative).

Methods: We included 185,962 women with 203 incident SLE cases (96 anti-dsDNA positive,107 anti-dsDNA negative) during 4,649,477 person-years of follow-up from the Nurses' Health Study (NHS) and NHSII cohorts. Read More

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Predictors of Aspiration Pneumonia and Mortality in Patients with Dysphagia.

Laryngoscope 2021 Jul 27. Epub 2021 Jul 27.

Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, U.S.A.

Objectives/hypothesis: To identify risk factors for pneumonia incidence in patients with dysphagia undergoing a videofluoroscopic swallow study (VFSS) in an outpatient tertiary-care center.

Study Design: Historical cohort study.

Methods: All individuals undergoing a VFSS between 10/02/13 and 07/30/15 were identified and followed historically for 2 years. Read More

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