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Point of Rocks, MD, United States

Misra R.,Texas A&M University | Patel T.,USUHS | Kotha P.,University of California at San Diego | Raji A.,Harvard University | And 7 more authors.
Journal of Diabetes and its Complications | Year: 2010

Background: Although studies of immigrant Asian Indians in other countries show high rates of diabetes (DM), metabolic syndrome (MetS), and cardiovascular disease (CVD), no randomized, population-based studies of this rapidly growing ethnic group exist in the US. Methods: The sample comprised 1038 randomly selected Asian Indian immigrants, aged 18 years and older at seven US sites. Prevalence of diabetes and MetS (age-adjusted and sex-adjusted means) was estimated and ANOVA was used to calculate gender and group differences (normoglycemia/impaired fasting glucose/diabetes) for CVD risk factors. Results: The mean age was 48.2 years. The majority of respondents were male, married, educated, and with some form of health insurance. Prevalence of diabetes was 17.4%, and 33% of the respondents had prediabetes. Cardiovascular risk factors, especially high levels of triglycerides, total cholesterol, LDL cholesterol, homocysteine, and C-reactive protein, and low levels of HDL cholesterol, were also prevalent; elevated lipoprotein(a) was not observed. The age-adjusted prevalence of MetS was 26.9% by the original NCEP/ATP III criteria, 32.7% by the modified NCEP/ATP III criteria, and 38.2% by the IDF criteria. The MetS rates for women, but not for men, increased with age using all three criteria. There was a progressive worsening of all metabolic parameters as individuals progressed from normal to IFG to diabetes. Conclusion: The prevalence rates of diabetes and MetS among US Asian Indians are higher than reported in earlier, nonrandomized, smaller surveys. These data provide a firm basis for future mechanistic and interventional studies. Source

Chai N.C.,Johns Hopkins University | Scher A.I.,USUHS | Moghekar A.,Johns Hopkins University | Bond D.S.,Brown Alpert Medical School | Peterlin B.L.,Johns Hopkins University
Headache | Year: 2014

Individually, both obesity and headache are conditions associated with a substantial personal and societal impact. Recent data support that obesity is comorbid with headache in general and migraine specifically, as well as with certain secondary headache conditions such as idiopathic intracranial hypertension. In the current manuscript, we first briefly review the epidemiology of obesity and common primary and secondary headache disorders individually. This is followed by a systematic review of the general population data evaluating the association between obesity and headache in general, and then obesity and migraine and tension-type headache disorders. Finally, we briefly discuss the data on the association between obesity and a common secondary headache disorder that is associated with obesity, idiopathic intracranial hypertension. Taken together, these data suggest that it is important for clinicians and patients to be aware of the headache/migraine- obesity association, given that it is potentially modifiable. Hypotheses for mechanisms of the obesity-migraine association and treatment considerations for overweight and obese headache sufferers are discussed in the companion manuscript, as part II of this topic. © 2014 American Headache Society. Source

Tinelli A.,Vito Fazzi Hospital | Mettler L.,University of Kiel | Malvasi A.,Santa Maria Hospital | Hurst B.,Assisted Reproduction Center | And 5 more authors.
Minimally Invasive Therapy and Allied Technologies | Year: 2014

Background: Myomectomy is one of the most common surgical procedures in gynecology and has implications on fertility and subsequent pregnancies. We compared the impact of surgical approach on blood loss during laparoscopic and abdominal intracapsular myomectomy. Material and methods: The evaluation comprised 124 fertile women with subserous or intramural myomas: 66 patients treated by laparoscopy and 58 patients treated by laparotomy. The intracapsular myoma enucleation technique was similar for both approaches. All procedures were analyzed for the evaluation of intra-and post-surgical blood loss and intra-and short-term post-operative surgical outcomes. Results: The operating time for laparoscopic intracapsular myomectomy was longer (95 ± 7.2 min vs. 63 ± 5.6, p < 0.0001), but was associated with reduced intra-(65 ± ml vs. 105 ± 5, p < 0.0001) and post-surgical blood loss (30 ± 5 vs. 60 ± 5 ml, p < 0.0001), as well as diminished application of pain relief medication (8 patients vs. 17, p < 0.05), compared to open intracapsular myomectomy. Conclusions: The surgical approach did not substantially affect the technique of intracapsular myomectomy; however, laparoscopy significantly reduced intra-and postoperative blood loss and resulted in better short-term outcomes than after open surgery. Our results underscore the advantages of trying to reduce the rate of laparotomic myomectomy, one of the leading surgical interventions associated with infertility and sterility. © 2014 Informa Healthcare. Source

Eberly M.D.,Uniformed Services University of the Health Sciences | Gorman G.H.,Uniformed Services University of the Health Sciences | Eide M.B.,Uniformed Services University of the Health Sciences | Olsen C.H.,USUHS | Rajnik M.,Uniformed Services University of the Health Sciences
Vaccine | Year: 2011

We conducted a retrospective review of all U.S. military dependents less than 5 years old hospitalized with rotavirus-associated gastroenteritis from July 2003 to June 2009. The two post-vaccine seasons showed a significant reduction of 62.4% (95% CI, 58.6-65.8, P< 0.001) in rotavirus gastroenteritis hospitalization rate compared to the three pre-vaccine seasons. Infants less than 12 months old showed the greatest reduction in incidence at 75.3%. A substantial decrease was also seen in unvaccinated children as well. Vaccine efficacy against hospitalization was 86.0% (95% CI, 77.7-91.3) after just a single dose. The overwhelming majority of children hospitalized for rotavirus since the introduction of the vaccine (ranging from 91.8 to 100% per season) had not received any of the rotavirus vaccine series. © 2010. Source

Dong T.,Uniformed Services University of the Health Sciences | Artino A.R.,Uniformed Services University of the Health Sciences | Durning S.J.,USUHS | Denton G.D.,USUHS
Medical Education | Year: 2012

Objectives This study was conducted to assess the associations between several clerkship process measures and students' clinical and examination performance in an internal medicine clerkship. Methods We collected data from the internal medicine clerkship at one institution over a 3-year period (classes of 2010-2012; n=507) and conducted correlation and multiple regression analyses. We examined the associations between clerkship process measures (student-reported number of patients evaluated, percentage of core problems encountered, total number of core problems encountered, total number of clinics attended) and four clerkship outcomes (clinical points [a weighted summation of a student's clinical grade recommendations], ambulatory clinical points [the out-patient portion of clinical points], examination points [a weighted summation of scores on three clerkship examinations], and National Board of Medical Examiners examination score). Results After controlling for pre-clerkship ability and gender, percentage of core problems was significantly associated with ambulatory clinical points (b=3.84, total model R 2=0.14). Further, number of patients evaluated was significantly associated with clinical points (b=0.19, total model R 2=0.22), but only for students who undertook first-quarter clerkships, who reported higher numbers of patients. Conclusions Notwithstanding a few positive (but small) associations, the results from this study suggest that clinical exposure is, at best, weakly associated with internal medicine clerkship performance. Discuss ideas arising from this article at '' © Blackwell Publishing Ltd 2012. Source

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