Characteristics of Mothers and Infants Living in Homeless Shelters and Public Housing in New York City

Maternal and Child Health Journal - Introduction Homelessness can result in poor health. The number of families with children living in NYC homeless shelters increased 55% from 2008 to 2014. Half...     

Opportunistic bone density screening for the abdominal radiologist using colored CT images: a pilot retrospective study

Abdominal Radiology - The purpose of the study was to develop an accurate and reproducible method for detecting low spinal bone density on abdominal CT images. For this IRB-approved HIPAA-compliant...     

Final results of the ReoPro readministration registry

Because of its potential for antigenicity, theoretical concerns related to readministration of abciximab have been raised. We conducted the ReoPro Readministration Registry to assess the efficacy and safety of abciximab readministration. A total of 1,342 patients who underwent percutaneous coronary intervention and who received abciximab for at least a second time were recruited. Safety end points were hypersensitivity reactions, major bleeding, and thrombocytopenia (TCP). Human antichimeric antibody (HACA) titers were determined before and after readministration. Procedural success was 98% and was not influenced by the number of courses of abciximab or the presence of HACA. There were no cases of anaphylaxis. There were 5 minor allergic reactions, none of which required termination of the infusion. Clinically significant bleeding occurred in 31 patients (2.3%), including 1 (0.07%) with intracranial hemorrhage. TCP (<100 x 10(9)/L) developed in 5% of patients; profound TCP (<20 x 10(9)/L) occurred in 2%. In patients who received abciximab within 1 month of a previous treatment (n = 115), the risk of developing TCP and profound TCP was 16.5% and 12.2%, respectively. Having a positive HACA before readministration was not correlated with adverse clinical outcomes or bleeding, but was associated with TCP (14.1% vs 4.4%, p = 0.002) and profound TCP (5.6% vs 1.6%, p = 0.036). Readministration of abciximab can be accomplished without severe allergic responses and with a bleeding and efficacy profile similar to first-time administration. However, the rate of severe and profound TCP is increased relative to first-time administration, particularly when the time between treatments is <30 days or when HACA is present.     

Dutch Cycling: Quantifying the Health and Related Economic Benefits

The Netherlands is well known for their high bicycle use. We used the Health Economic Assessment Tool and life table calculations to quantify the population-level health benefits from Dutch cycling levels. Cycling prevents about 6500 deaths each year, and Dutch people have half-a-year-longer life expectancy because of cycling. These health benefits correspond to more than 3% of the Dutch gross domestic product. Our study confirmed that investments in bicycle-promoting policies (e.g., improved bicycle infrastructure and facilities) will likely yield a high cost–benefit ratio in the long term.The Netherlands is well known for their high cycling levels.1,2 Currently, about 27% of all trips in the Netherlands are made by bicycle.3 Investments in bicycle paths, bicycle parking, traffic calming, and other policies contribute to these high cycling levels; therefore, the Dutch approach is internationally recognized as an example for other countries.1,2 Although the health benefits of cycling as a means to reduce the risk of sedentary lifestyle diseases and all-cause mortality are well known,4–6 no previous study has actually quantified the health benefits and related economic benefits at a population level in the Netherlands, which has the highest level of bicycle use in the world.1 Quantifying and monetizing these benefits are important to inform policymakers in the field of transport.7 Therefore, we examined the health benefits and health-related economic benefits of population cycling levels in the Netherlands.     

Prevalence and Correlates of Skin Cancer Screening among Middle-aged and Older White Adults in the United States

Background

Total skin examinations performed by a physician have the potential to identify skin cancers at an early stage, when they are most amenable to successful treatment. This study examined the prevalence rates of, and factors associated with, receipt of a total skin examination by a dermatologist or other doctor during the past year.

Methods

The participants were 10,486 white men and women aged 50 years and older drawn from a random sample of 31,428 adults aged 18 years and older who took part in the 2005 National Health Interview Survey. The data were collected via in-person interviews, and participants answered questions about their receipt of total skin examinations, their demographic characteristics, health and health care access, receipt of other cancer screenings, and personal and family history of skin cancer.

Results

Sixteen percent of men and 13% of women reported having a skin examination in the past year. The factors associated with lowest skin examination rates in multivariable analyses included younger age (50-64 years), lower education level, lack of screening for colorectal, breast (women only), and prostate cancers (men only), and lack of a personal history of skin cancer.

Conclusions

Rates of having a skin examination in the past year were low among men and women and among all sub-groups. Systematic efforts are needed to increase screening rates among higher risk individuals. Physicians should be particularly aware of the need to consider skin cancer screening examinations for their male, elderly patients, as well as individuals with less education.