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Daniel G. Whitney - One of the best experts on this subject based on the ideXlab platform.
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The respiratory Disease burden of non-traumatic fractures for adults with cerebral palsy
Bone reports, 2020Co-Authors: Jonathan P. Etter, Sanjana Kannikeswaran, Edward A. Hurvitz, Mark D. Peterson, Michelle S. Caird, Karl J. Jepsen, Daniel G. WhitneyAbstract:Background Individuals with cerebral palsy (CP) are vulnerable to non-trauma fracture (NTFx) and premature mortality due to respiratory Disease (RD); however, very little is known about the contribution of NTFx to RD risk among adults with CP. The purpose of this study was to determine if NTFx is a risk factor for incident RD and if NTFx exacerbates RD risk in the adult CP population. Methods Data from 2011 to 2016 Optum Clinformatics® Data Mart and a random 20% sample Medicare fee-for-service were used for this retrospective cohort study. Diagnosis codes were used to identify adults (18+ years) with and without CP, NTFx, incident RD at 3-, 6-, 12-, and 24-month time points (pneumonia, chronic obstructive pulmonary Disease, interstitial/Pleura Disease), and comorbidities. Crude incidence rates per 100 person years of RD were estimated. Cox regression estimated hazard ratios (HR and 95% confidence interval [CI]) for RD measures, comparing: (1) CP and NTFx (CP + NTFx); (2) CP without NTFx (CP w/o NTFx); (3) without CP and with NTFx (w/o CP + NTFx); and (4) without CP and without NTFx (w/o CP w/o NTFx) after adjusting for demographics and comorbidities. Results The crude incidence rate was elevated for CP + NTFx vs. CP w/o NTFx and w/o CP + NTFx for each RD measure. After adjustments, the HR was elevated for CP + NTFx vs. CP w/o NTFx for pneumonia and interstitial/Pleura Disease at all time points (all P
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Risk for respiratory and cardiovascular Disease and mortality after non-trauma fracture and the mediating effects of respiratory and cardiovascular Disease on mortality risk among adults with epilepsy
Epilepsy research, 2020Co-Authors: Daniel G. Whitney, Sanjana Kannikeswaran, Daniel WhibleyAbstract:Abstract Background Non-trauma fracture (NTFx), an indicator of skeletal fragility, is a risk factor for mortality among adults with epilepsy. NTFx may elicit its effect on mortality through development of respiratory Disease (RD) and cardiovascular Disease (CVD). Therefore, the objective was to determine if NTFx increases risk for RD and CVD, and if incident RD and CVD mediates the association between NTFx and mortality for adults with epilepsy. Methods Data were gathered from Optum Clinformatics® Data Mart years 2011–2016 for this retrospective cohort study. Diagnosis codes identified adults (≥18 years) with epilepsy, NTFx, RD (pneumonia, chronic obstructive pulmonary Disease, interstitial/Pleura Disease), CVD (ischemic heart Disease, heart failure, cerebrovascular Disease), and baseline comorbidities. Crude incidence rate (IR) and crude IR ratio (IRR and 95 % confidence intervals [CI]) was estimated for mortality and incidence of RD and CVD for up to 2 years of follow up. Cox regression estimated hazard ratios (HR and 95 % CI) for each outcome, comparing adults with vs. without NTFx after adjusting for sociodemographics and baseline comorbidities. Separate mediation analyses estimated the extent that incident RD and CVD mediated the association between NTFx and mortality. Results Adults with epilepsy with vs. without NTFx had a higher crude incidence of mortality (IRR = 2.42; 95 %CI = 2.24–2.60) and each RD and CVD measure (IRR = 1.60–2.02). After adjustments, the HR remained elevated for mortality (HR = 1.66; 95 %CI = 1.54–1.79) and each RD and CVD measure (HR = 1.18–1.61). Incident pneumonia and interstitial/Pleura Disease mediated 9.82 % and 7.51 %, respectively, of the association between NTFx and mortality. Conclusions In a relatively short follow up of 2 years, NTFx was a robust risk factor for mortality, RD, and CVD among adults with epilepsy, and post-NTFx incidence of RD mediated a portion of the association between NTFx and mortality.
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Nontrauma fracture increases risk for respiratory Disease among adults with cerebral palsy.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2020Co-Authors: Daniel G. WhitneyAbstract:Individuals with cerebral palsy (CP) manifest skeletal fragility problems early in life and are vulnerable to nontrauma fracture (NTFx), which may exacerbate the risk of respiratory Disease (RD)- the main cause of premature mortality for this population. The purpose of this study was to determine if adults with CP had a greater 12-month risk of RD post-NTFx compared to adults without CP. Data from 2011 to 2017 were leveraged from Optum Clinformatics Data Mart; a claims database from a single private payer in the United States diagnostic codes were used to identify adults (≥18 years) with and without CP, NTFx, incident RD, and pre-NTFx cardiometabolic Diseases. Cox proportional hazards regression models were used to compare 12-month RD incidence following NTFx with adjustment for sociodemographics and cardiometabolic Diseases. Mean age (SD) at baseline was 57.5 (18.4) for adults with CP (n = 646) and 61.8 (19.7) for adults without CP (n = 321,482). During the follow-up, 172 adults with CP (26.6%) and 73 937 adults without CP (23.0%) developed RD. Adults with CP had higher 12-month post-NTFx RD incidence compared to adults without CP (hazard ratio [HR] = 1.20; 95% confidence interval [CI] = 1.03-1.37). When stratified by the RD subtype, adults with CP had a higher incidence of pneumonia (HR = 2.15; 95% CI = 1.56-2.95), interstitial/Pleura Disease (HR = 2.13; 95% CI = 1.53-2.96), and other RD (eg, respiratory failure; HR = 2.33; 95% CI = 1.82-2.98), but not acute respiratory infection (HR = 0.93; 95% CI = 0.75-1.15) or chronic obstructive pulmonary Disease (HR = 1.15; 95% CI = 0.86-1.53). Among privately insured adults with CP, NTFx is associated with greater risk of RD among adults with vs without CP.
Daniel Whibley - One of the best experts on this subject based on the ideXlab platform.
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Risk for respiratory and cardiovascular Disease and mortality after non-trauma fracture and the mediating effects of respiratory and cardiovascular Disease on mortality risk among adults with epilepsy
Epilepsy research, 2020Co-Authors: Daniel G. Whitney, Sanjana Kannikeswaran, Daniel WhibleyAbstract:Abstract Background Non-trauma fracture (NTFx), an indicator of skeletal fragility, is a risk factor for mortality among adults with epilepsy. NTFx may elicit its effect on mortality through development of respiratory Disease (RD) and cardiovascular Disease (CVD). Therefore, the objective was to determine if NTFx increases risk for RD and CVD, and if incident RD and CVD mediates the association between NTFx and mortality for adults with epilepsy. Methods Data were gathered from Optum Clinformatics® Data Mart years 2011–2016 for this retrospective cohort study. Diagnosis codes identified adults (≥18 years) with epilepsy, NTFx, RD (pneumonia, chronic obstructive pulmonary Disease, interstitial/Pleura Disease), CVD (ischemic heart Disease, heart failure, cerebrovascular Disease), and baseline comorbidities. Crude incidence rate (IR) and crude IR ratio (IRR and 95 % confidence intervals [CI]) was estimated for mortality and incidence of RD and CVD for up to 2 years of follow up. Cox regression estimated hazard ratios (HR and 95 % CI) for each outcome, comparing adults with vs. without NTFx after adjusting for sociodemographics and baseline comorbidities. Separate mediation analyses estimated the extent that incident RD and CVD mediated the association between NTFx and mortality. Results Adults with epilepsy with vs. without NTFx had a higher crude incidence of mortality (IRR = 2.42; 95 %CI = 2.24–2.60) and each RD and CVD measure (IRR = 1.60–2.02). After adjustments, the HR remained elevated for mortality (HR = 1.66; 95 %CI = 1.54–1.79) and each RD and CVD measure (HR = 1.18–1.61). Incident pneumonia and interstitial/Pleura Disease mediated 9.82 % and 7.51 %, respectively, of the association between NTFx and mortality. Conclusions In a relatively short follow up of 2 years, NTFx was a robust risk factor for mortality, RD, and CVD among adults with epilepsy, and post-NTFx incidence of RD mediated a portion of the association between NTFx and mortality.
Sanjana Kannikeswaran - One of the best experts on this subject based on the ideXlab platform.
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The respiratory Disease burden of non-traumatic fractures for adults with cerebral palsy
Bone reports, 2020Co-Authors: Jonathan P. Etter, Sanjana Kannikeswaran, Edward A. Hurvitz, Mark D. Peterson, Michelle S. Caird, Karl J. Jepsen, Daniel G. WhitneyAbstract:Background Individuals with cerebral palsy (CP) are vulnerable to non-trauma fracture (NTFx) and premature mortality due to respiratory Disease (RD); however, very little is known about the contribution of NTFx to RD risk among adults with CP. The purpose of this study was to determine if NTFx is a risk factor for incident RD and if NTFx exacerbates RD risk in the adult CP population. Methods Data from 2011 to 2016 Optum Clinformatics® Data Mart and a random 20% sample Medicare fee-for-service were used for this retrospective cohort study. Diagnosis codes were used to identify adults (18+ years) with and without CP, NTFx, incident RD at 3-, 6-, 12-, and 24-month time points (pneumonia, chronic obstructive pulmonary Disease, interstitial/Pleura Disease), and comorbidities. Crude incidence rates per 100 person years of RD were estimated. Cox regression estimated hazard ratios (HR and 95% confidence interval [CI]) for RD measures, comparing: (1) CP and NTFx (CP + NTFx); (2) CP without NTFx (CP w/o NTFx); (3) without CP and with NTFx (w/o CP + NTFx); and (4) without CP and without NTFx (w/o CP w/o NTFx) after adjusting for demographics and comorbidities. Results The crude incidence rate was elevated for CP + NTFx vs. CP w/o NTFx and w/o CP + NTFx for each RD measure. After adjustments, the HR was elevated for CP + NTFx vs. CP w/o NTFx for pneumonia and interstitial/Pleura Disease at all time points (all P
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Risk for respiratory and cardiovascular Disease and mortality after non-trauma fracture and the mediating effects of respiratory and cardiovascular Disease on mortality risk among adults with epilepsy
Epilepsy research, 2020Co-Authors: Daniel G. Whitney, Sanjana Kannikeswaran, Daniel WhibleyAbstract:Abstract Background Non-trauma fracture (NTFx), an indicator of skeletal fragility, is a risk factor for mortality among adults with epilepsy. NTFx may elicit its effect on mortality through development of respiratory Disease (RD) and cardiovascular Disease (CVD). Therefore, the objective was to determine if NTFx increases risk for RD and CVD, and if incident RD and CVD mediates the association between NTFx and mortality for adults with epilepsy. Methods Data were gathered from Optum Clinformatics® Data Mart years 2011–2016 for this retrospective cohort study. Diagnosis codes identified adults (≥18 years) with epilepsy, NTFx, RD (pneumonia, chronic obstructive pulmonary Disease, interstitial/Pleura Disease), CVD (ischemic heart Disease, heart failure, cerebrovascular Disease), and baseline comorbidities. Crude incidence rate (IR) and crude IR ratio (IRR and 95 % confidence intervals [CI]) was estimated for mortality and incidence of RD and CVD for up to 2 years of follow up. Cox regression estimated hazard ratios (HR and 95 % CI) for each outcome, comparing adults with vs. without NTFx after adjusting for sociodemographics and baseline comorbidities. Separate mediation analyses estimated the extent that incident RD and CVD mediated the association between NTFx and mortality. Results Adults with epilepsy with vs. without NTFx had a higher crude incidence of mortality (IRR = 2.42; 95 %CI = 2.24–2.60) and each RD and CVD measure (IRR = 1.60–2.02). After adjustments, the HR remained elevated for mortality (HR = 1.66; 95 %CI = 1.54–1.79) and each RD and CVD measure (HR = 1.18–1.61). Incident pneumonia and interstitial/Pleura Disease mediated 9.82 % and 7.51 %, respectively, of the association between NTFx and mortality. Conclusions In a relatively short follow up of 2 years, NTFx was a robust risk factor for mortality, RD, and CVD among adults with epilepsy, and post-NTFx incidence of RD mediated a portion of the association between NTFx and mortality.
J C Mcdonald - One of the best experts on this subject based on the ideXlab platform.
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sword 98 surveillance of work related and occupational respiratory Disease in the uk
Occupational Medicine, 1999Co-Authors: John D Meyer, D L Holt, N M Cherry, J C McdonaldAbstract:The SWORD surveillance scheme, now 10 years old, uses systematic reporting from physicians to provide a picture of the incidence of occupational respiratory Disease in the United Kingdom. An estimated total of 2966 incident cases was derived from reports by chest and occupational physicians during the 1998 calendar year. Occupational asthma continues to be the most-reported respiratory condition, with an estimated 822 cases (27% of total cases). The proportion of cases of mesothelioma (23%), benign Pleura! Disease (21 %) pneumoconiosis (7%) and inhalation injuries (6%) remain similar to those estimated in past years, although fewer cases overall were reported. The most commonly identified agents causing asthma in 1998 were enzymes, isocyanates, laboratory animals and insects, colophony and fluxes, flour, latex, and glutaraldehyde. An increased incidence of respiratory Diseases of short latency was seen in mining, whilst cases in chemical, mineral products and motor vehicle manufacture remained high; lower rates were noted in wood products and textile manufacture when compared with 1997 figures. Inhalation accidents over the past 3 years were reviewed; gaseous agents and combustion products accounted for nearly half of cases. High rates for inhalation injuries were seen in coal miners, fuel production, motor vehicle manufacturing, water purification, and chemical manufacturing
Tao Rongzhong - One of the best experts on this subject based on the ideXlab platform.
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A retrospective review of 218 Video-assisted thoracic surgery cases
Journal of Clinical Pulmonary Medicine, 2006Co-Authors: Tao RongzhongAbstract:Objective To investigate the application and results of minimally invasive operations with video-assisted thoracic surgery.Methods 218 cases of video-assisted thoracic surgery with or without small incision in chest have been studied.The site of Disease included Pleura,chest,lung,mediastinum,esophagus,pericardial,diaphragm.Results All these cases were performaed by VATS with or without small incision.No any cases required access incisions.No patients died during operation,and no severe complications were founded in these cases.No patients required blood transfusion.Conclusion Video-assisted thoracic surgery is an excellent alternative treatment for Pleura Disease and chest Diseases,pneumothorax,blebs,and bullous Disease,pericardiectomy,empyema,Pleural effusion,and chest trauma(hemothorax),pericardial Disease,mediastinal tumor,lung isolated nodulus,esophagus benign Diseases.Video-assisted thoracic surgery allows safe procedure complete in lobectomy and pneumonectomy with some special instruments such as stapler.An appropriate lymph node dissection be performed using VATS compare with routine thoracotomy.