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Artikel ; Online: Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes.

Barbara H Braffett / Madeline Murguia Rice / Heather A Young / John M Lachin

PLoS ONE, Vol 14, Iss 1, p e

2019 Band 0210367

Abstract: Studies have demonstrated the adverse effects of smoking on the risk of microvascular complications; however, few have also examined the potential mediating effects of glycemic control. Using data from the Diabetes Control and Complications Trial (DCCT ... ...

Abstract	Studies have demonstrated the adverse effects of smoking on the risk of microvascular complications; however, few have also examined the potential mediating effects of glycemic control. Using data from the Diabetes Control and Complications Trial (DCCT 1983-1993), we describe the acute and long-term risks of smoking on glycemic control and microvascular complications in a well-characterized cohort of participants with type 1 diabetes. The DCCT recorded self-reported smoking behaviors, glycemic exposure based on HbA1c, and complications status. Generalized linear mixed models were used to assess whether time-dependent measurements of smoking predict HbA1c levels. Cox proportional hazard models were used to assess time-dependent smoking exposures as predictors of retinopathy and nephropathy. During a mean of 6.5 years of follow-up, current smokers had consistently higher HbA1c values and were at a higher risk of retinopathy and nephropathy compared with former and never smokers. These risk differences were attenuated after adjusting for HbA1c suggesting that the negative association of smoking on glycemic control is partially responsible for the adverse association of smoking on the risk of complications in type 1 diabetes. These findings support the potential for a beneficial effect of smoking cessation on complications in type 1 diabetes.
Schlagwörter	Medicine ; R ; Science ; Q
Sprache	Englisch
Erscheinungsdatum	2019-01-01T00:00:00Z
Verlag	Public Library of Science (PLoS)
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: Association between increasing agricultural use of 2,4-D and population biomarkers of exposure

Marlaina S. Freisthler / C. Rebecca Robbins / Charles M. Benbrook / Heather A. Young / David M. Haas / Paul D. Winchester / Melissa J. Perry

Environmental Health, Vol 21, Iss 1, Pp 1-

findings from the National Health and Nutrition Examination Survey, 2001–2014

2022 Band 11

Abstract: Abstract Background 2,4-Dichlorophenoxyacetic acid (2,4-D) is one of the most extensively used herbicides in the United States. In 2012, 2,4-D was the most widely used herbicide in non-agricultural settings and the fifth most heavily applied pesticide in ...

Abstract	Abstract Background 2,4-Dichlorophenoxyacetic acid (2,4-D) is one of the most extensively used herbicides in the United States. In 2012, 2,4-D was the most widely used herbicide in non-agricultural settings and the fifth most heavily applied pesticide in the US agricultural sector. The objective of this study was to examine trends in 2,4-D urinary biomarker concentrations to determine whether increases in 2,4-D application in agriculture are associated with increases in biomonitoring levels of urine 2,4-D. Methods Data from the National Health and Nutrition Examination Survey (NHANES) with available urine 2,4-D biomarker measurements from survey cycles between 2001 and 2014 were utilized. Urine 2,4-D values were dichotomized using the highest limit of detection (LOD) across all cycles (0.40 μg/L or 0.4 ppb). Agricultural use of 2,4-D was estimated by compiling publicly available federal and private pesticide application data. Logistic regression models adjusted for confounders were fitted to evaluate the association between agricultural use of 2,4-D and urine 2,4-D level above the dichotomization threshold. Results Of the 14,395 participants included in the study, 4681 (32.5%) had urine 2,4-D levels above the dichotomization threshold. The frequency of participants with high 2,4-D levels increased significantly (p < .0001), from a low of 17.1% in 2001–2002 to a high of 39.6% in 2011–2012. The adjusted odds of high urinary 2,4-D concentrations associated with 2,4-D agricultural use (per ten million pounds applied) was 2.268 (95% CI: 1.709, 3.009). Children ages 6–11 years (n = 2288) had 2.1 times higher odds of having high 2,4-D urinary concentrations compared to participants aged 20–59 years. Women of childbearing age (age 20–44 years) (n = 2172) had 1.85 times higher odds than men of the same age. Conclusions Agricultural use of 2,4-D has increased substantially from a low point in 2002 and it is predicted to increase further in the coming decade. Because increasing use is likely to increase population level ...
Schlagwörter	Environmental epidemiology ; Environmental exposure ; Pesticides ; Industrial medicine. Industrial hygiene ; RC963-969 ; Public aspects of medicine ; RA1-1270
Thema/Rubrik (Code)	333
Sprache	Englisch
Erscheinungsdatum	2022-02-01T00:00:00Z
Verlag	BMC
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: The Association Between Race, Obesity, and Sperm Quality Among Men Attending a University Physician Practice in Washington, DC

Nathan L. McCray / Heather A. Young / Michael S. Irwig / David Frankfurter / Arnold M. Schwartz / Jeannine Witmyer / Marijane Hynes / Vimala V. Jayanthi / Mia Marcus / Mihir Patel / Melissa J. Perry

American Journal of Men's Health, Vol

2020 Band 14

Abstract: A decades-long decline in sperm counts in Western countries has coincided with an increase in obesity rates, prompting study into their association. Few of these studies have incorporated men of color, the sperm health of whom is relatively unknown. The ... ...

Abstract	A decades-long decline in sperm counts in Western countries has coincided with an increase in obesity rates, prompting study into their association. Few of these studies have incorporated men of color, the sperm health of whom is relatively unknown. The present exploratory study evaluated the association between body mass index (BMI), race, ethnicity, and sperm parameters among a diverse sample of U.S. men attending a Washington, DC physician practice. Semen samples were collected and processed at a single laboratory and sperm concentration, motility, morphology, and count were evaluated according to World Health Organization (WHO) 5th edition criteria. Multivariate models accounted for covariates related to sperm health. The study population ( n = 128) was largely obese (45.3%) or overweight (34.4%), and 36.0% were black or Hispanic. Black men had lower adjusted sperm concentration compared to white men (75.0 million/mL to 107.4 million/mL, p = .01) and were more likely to have oligozoospermia ( p = .01), asthenozoospermia ( p = .004), and low sperm count ( p < .0001). Hispanic men had higher adjusted sperm concentration compared to non-Hispanic men (124.5 million/mL to 62.1 million/mL, p = .007) and were less likely to have teratozoospermia ( p = .001). Obesity and BMI were associated with lower sperm motility and count in crude models only. Given the study’s sample size its findings should be interpreted with caution but align with the limited epidemiological literature to date that has evaluated racial and ethnic differences in semen quality. Heightened clinical research attention is needed to ensure men of color are included in representative numbers in studies of urologic and andrologic health.
Schlagwörter	Medicine ; R
Thema/Rubrik (Code)	360
Sprache	Englisch
Erscheinungsdatum	2020-05-01T00:00:00Z
Verlag	SAGE Publishing
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: Sync and Swim

Alexander Ross / Humaira Jami / Heather A. Young / Richard Katz

Journal of Primary Care & Community Health, Vol

2013 Band 4

Abstract: Background: Medication nonadherence is associated with higher cost of care and poor outcomes. Medication refill consolidation (synchronization of refill dates for patients on multiple drugs) is an important component of regimen complexity. We presumed ... ...

Abstract	Background: Medication nonadherence is associated with higher cost of care and poor outcomes. Medication refill consolidation (synchronization of refill dates for patients on multiple drugs) is an important component of regimen complexity. We presumed that Medicaid patients with a 30-day medication supply limit would have significant difficulty with refill consolidation. We evaluated regimen complexity and refill consolidation in relation to medication adherence in the Medicaid population. Methods: A survey was administered to 50 Medicaid patients taking 2 or more daily medications in the outpatient setting. The survey included demographics, 13 items related to medication and pharmacy history, and 10 items related to medication regimen complexity and refill consolidation. Chi-square analysis was used to assess the relationship between adherence and missed medication doses due to regimen complexity. Wilcoxon rank sum test was used to determine association between total number of prescribing providers and number of daily medications with various aspects of regimen complexity. Results: 52% were required to go to the pharmacy more than once per month to keep all of their medications filled and 46% missed a day or more of medication because their medications must be refilled on different dates. Those who missed a day or more of medication because of need to refill prescriptions on different days had higher number of prescriptions ( P = .03) and higher number of prescribers ( P = .03). Conclusion: Medicaid patients had low medication adherence in the context of high regimen complexity and poor refill consolidation. This population would benefit from interventions focused on improving synchronization of medication refills.
Schlagwörter	Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
Thema/Rubrik (Code)	616
Sprache	Englisch
Erscheinungsdatum	2013-10-01T00:00:00Z
Verlag	SAGE Publishing
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: Interruptions of antiretroviral therapy in children and adolescents with HIV infection in clinical practice

Natella Rakhmanina / Kam S Lam / Jaclyn Hern / Heather A Young / Alex Walters / Amanda D Castel

Journal of the International AIDS Society , Vol 19, Iss 1, Pp 1-

a retrospective cohort study in the USA

2016 Band 6

Abstract: Introduction: Changes in combination antiretroviral therapy (cART) throughout childhood challenge the continuity of paediatric HIV treatment. This study aimed to evaluate the prevalence of treatment interruption (TI), including lamivudine (3TC) ... ...

Abstract	Introduction: Changes in combination antiretroviral therapy (cART) throughout childhood challenge the continuity of paediatric HIV treatment. This study aimed to evaluate the prevalence of treatment interruption (TI), including lamivudine (3TC) monotherapy, and the relationship of TI to virologic and immunologic parameters in HIV-infected paediatric patients. Methods: Nested within a prospective observational study of a city-wide cohort of HIV-infected persons in the District of Columbia, this sub-study collected retrospective data on antiretroviral therapy, enrolment (endpoint) and historic (lifelong) CD4 counts and HIV RNA viral load (VL) of the paediatric cohort. TI was defined as interruption of cART ≥4 consecutive weeks. Data on TI, including 3TC monotherapy TI (MTI), were collected. Descriptive statistics and univariate testing were used to compare children with TI and MTI to children on continuous treatment (CT). Results: Thirty-eight (28%) out of 136 enrolled children (median age=12.9 years) experienced TI, with 14 (37%) of those placed on 3TC MTI. Significantly lower endpoint median CD4 counts (598 cells/mm3 vs. 815 cells/mm3; p=0.003) and CD4% (27.5% vs. 33%; p=0.006) were observed in the TI cohort as compared to the CT cohort. The median endpoint VL in the overall TI cohort was ~4 times higher than among the CT cohort (1427 copies/mL vs. 5581 copies/mL; p<0.0001). After a median TI duration of one year, a majority (n=31; 82%) of patients with TI restarted cART, including 100% of those with total TI and 53% of those on MTI, respectively. Conclusions: In our study, we observed high frequency of the TI in HIV in paediatric HIV clinical practice. All TIs, including 3TC MTI, were associated with significantly lower endpoint median CD4 counts and higher median VLs, as compared to CT in paediatric patients. The high frequency of TI and associated poor outcomes suggest a need for a better strategy in managing the course of the paediatric and adolescent cART.
Schlagwörter	HIV ; children ; treatment interruption ; antiretroviral therapy ; lamivudine monotherapy ; General Works ; A ; Medicine ; R ; Political science ; J ; Social Sciences ; H ; Immunologic diseases. Allergy ; RC581-607
Thema/Rubrik (Code)	610
Sprache	Englisch
Erscheinungsdatum	2016-10-01T00:00:00Z
Verlag	Wiley
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel: Dialkyl phosphate urinary metabolites and chromosomal abnormalities in human sperm

Figueroa, Zaida I / Dana Boyd Barr / George Gray / Heather A. Young / John D. Meeker / Melissa J. Perry / Sheena E. Martenies

Environmental Research. 2015 Nov., v. 143

2015

Abstract: The past decade has seen numerous human health studies seeking to characterize the impacts of environmental exposures, such as organophosphate (OP) insecticides, on male reproduction. Despite an extensive literature on OP toxicology, many hormone- ... ...

Abstract	The past decade has seen numerous human health studies seeking to characterize the impacts of environmental exposures, such as organophosphate (OP) insecticides, on male reproduction. Despite an extensive literature on OP toxicology, many hormone-mediated effects on the testes are not well understood.This study investigated environmental exposures to OPs and their association with the frequency of sperm chromosomal abnormalities (i.e., disomy) among adult men.Men (n=159) from a study assessing the impact of environmental exposures on male reproductive health were included in this investigation. Multi-probe fluorescence in situ hybridization (FISH) for chromosomes X, Y, and 18 was used to determine XX18, YY18, XY18 and total disomy in sperm nuclei. Urine was analyzed using gas chromatography coupled with mass spectrometry for concentrations of dialkyl phosphate (DAP) metabolites of OPs [dimethylphosphate (DMP); dimethylthiophosphate (DMTP); dimethyldithiophosphate (DMDTP); diethylphosphate (DEP); diethylthiophosphate (DETP); and diethyldithiophosphate (DEDTP)]. Poisson regression was used to model the association between OP exposures and disomy measures. Incidence rate ratios (IRRs) were calculated for each disomy type by exposure quartiles for most metabolites, controlling for age, race, BMI, smoking, specific gravity, total sperm concentration, motility, and morphology.A significant positive trend was seen for increasing IRRs by exposure quartiles of DMTP, DMDTP, DEP and DETP in XX18, YY18, XY18 and total disomy. A significant inverse association was observed between DMP and total disomy. Findings for total sum of DAP metabolites concealed individual associations as those results differed from the patterns observed for each individual metabolite. Dose-response relationships appeared nonmonotonic, with most of the increase in disomy rates occurring between the second and third exposure quartiles and without additional increases between the third and fourth exposure quartiles.This is the first epidemiologic study of this size to examine the relationship between environmental OP exposures and human sperm disomy outcomes. Our findings suggest that increased disomy rates were associated with specific DAP metabolites, suggesting that the impacts of OPs on testis function need further characterization in epidemiologic studies.
Schlagwörter	adults ; body mass index ; chromosome aberrations ; dose response ; environmental exposure ; environmental impact ; epidemiological studies ; fluorescence in situ hybridization ; gas chromatography ; human health ; humans ; insecticides ; males ; mass spectrometry ; metabolites ; phosphates ; specific gravity ; sperm concentration ; spermatozoa ; testes ; toxicology ; urine ; X chromosome ; Y chromosome
Sprache	Englisch
Erscheinungsverlauf	2015-11
Umfang	p. 256-265.
Erscheinungsort	Elsevier Inc.
Dokumenttyp	Artikel
ZDB-ID	205699-9
ISSN	1096-0953 ; 0013-9351
ISSN (online)	1096-0953
ISSN	0013-9351
DOI	10.1016/j.envres.2015.10.021
Datenquelle	NAL Katalog (AGRICOLA)

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Artikel ; Online: Digitally recorded and remotely classified lung auscultation compared with conventional stethoscope classifications among children aged 1–59 months enrolled in the Pneumonia Etiology Research for Child Health (PERCH) case–control study

Eric D McCollum / Charl Verwey / W Abdullah Brooks / Donald M Thea / Katherine L O'Brien / Melinda C Power / Daniel E Park / Nora L Watson / Charatdao Bunthi / Mounya Elhilali / Lokman Hossain / Shabir A Madhi / David P Moore / Justin Mulindwa / Daniel Feikin / David R Murdoch / J Anthony G Scott / Yasmin Jahan / Christopher Focht /

Laura L Hammitt / Stephen R C Howie / Karen L Kotloff / Orin S Levine / Tussanee Amorninthapichet / Juliet Awori / Bernard Ebruke / Melissa Higdon / Sathapana Naorat / Christine Prosperi / Somsak Thamthitiwat / Kathleen A Jablonski / Heather A Young / Maria Deloria Knoll

BMJ Open Respiratory Research, Vol 9, Iss

2022 Band 1

Abstract: Background Diagnosis of pneumonia remains challenging. Digitally recorded and remote human classified lung sounds may offer benefits beyond conventional auscultation, but it is unclear whether classifications differ between the two approaches. We ... ...

Abstract	Background Diagnosis of pneumonia remains challenging. Digitally recorded and remote human classified lung sounds may offer benefits beyond conventional auscultation, but it is unclear whether classifications differ between the two approaches. We evaluated concordance between digital and conventional auscultation.Methods We collected digitally recorded lung sounds, conventional auscultation classifications and clinical measures and samples from children with pneumonia (cases) in low-income and middle-income countries. Physicians remotely classified recordings as crackles, wheeze or uninterpretable. Conventional and digital auscultation concordance was evaluated among 383 pneumonia cases with concurrently (within 2 hours) collected conventional and digital auscultation classifications using prevalence-adjusted bias-adjusted kappa (PABAK). Using an expanded set of 737 cases that also incorporated the non-concurrently collected assessments, we evaluated whether associations between auscultation classifications and clinical or aetiological findings differed between conventional or digital auscultation using χ2 tests and logistic regression adjusted for age, sex and site.Results Conventional and digital auscultation concordance was moderate for classifying crackles and/or wheeze versus neither crackles nor wheeze (PABAK=0.50), and fair for crackles-only versus not crackles-only (PABAK=0.30) and any wheeze versus no wheeze (PABAK=0.27). Crackles were more common on conventional auscultation, whereas wheeze was more frequent on digital auscultation. Compared with neither crackles nor wheeze, crackles-only on both conventional and digital auscultation was associated with abnormal chest radiographs (adjusted OR (aOR)=1.53, 95% CI 0.99 to 2.36; aOR=2.09, 95% CI 1.19 to 3.68, respectively); any wheeze was inversely associated with C-reactive protein >40 mg/L using conventional auscultation (aOR=0.50, 95% CI 0.27 to 0.92) and with very severe pneumonia using digital auscultation (aOR=0.67, 95% CI 0.46 to 0.97). ...
Schlagwörter	Medicine ; R ; Diseases of the respiratory system ; RC705-779
Thema/Rubrik (Code)	070
Sprache	Englisch
Erscheinungsdatum	2022-02-01T00:00:00Z
Verlag	BMJ Publishing Group
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: Care of HIV-Infected Pregnant Women in MaternalÃ¢Â€Â“Fetal Medicine Programs

David M. Parenti / Heather A. Young / Susanne L. Bathgate / Peter A. Sklar

Infectious Diseases in Obstetrics and Gynecology, Vol 9, Iss 2, Pp 81-

2001 Band 87

Abstract: Objective: To survey the evolution over the past decade of attitudes and practices of obstetricians in maternalÃ¢Â€Â“fetal medicine fellowship programs regarding the management of human immunodeficiency virus (HIV)-infected pregnant women. ...

Abstract	Objective: To survey the evolution over the past decade of attitudes and practices of obstetricians in maternalÃ¢Â€Â“fetal medicine fellowship programs regarding the management of human immunodeficiency virus (HIV)-infected pregnant women.
Schlagwörter	Gynecology and obstetrics ; RG1-991 ; Medicine ; R ; DOAJ:Gynecology and Obstetrics ; DOAJ:Medicine (General) ; DOAJ:Health Sciences ; Immunologic diseases. Allergy ; RC581-607 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; DOAJ:Allergy and Immunology
Sprache	Englisch
Erscheinungsdatum	2001-01-01T00:00:00Z
Verlag	Hindawi Publishing Corporation
Dokumenttyp	Artikel ; Online
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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