Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-15 (of 15 Records) |
Query Trace: Mendola P[original query] |
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Hereditary breast and ovarian cancer: Risk assessment in minority women and provider knowledge gaps
Paris NM , Gabram-Mendola SGA , Kerber AS , O'Connor J , Crane BE , Martin ML , Traxler LB , Matthews R , Parker C , Webster R , Schmitt E , Meaney-Delman D , Nair N , Green VL , Bellcross CA . J Community Support Oncol 2016 14 (6) 261-267 Background: The Georgia Breast Cancer Genomics Project identifed minority and underserved women at high risk for hereditary breast and ovarian cancer based on family history. Education, web-based screening, genetic counseling, and testing were provided in public health and primary care settings in accordance with evidence-based recommendations and guidelines. Objectives: To assess risk of hereditary breast and ovarian cancer (HBOC) among minority and underserved women, provide genetic services according to evidence-based guidelines, and evaluate provider knowledge of HBOC. Methods: The Georgia Department of Public Health established this project through a cooperative agreement with the Centers for Disease Control and Prevention. HBOC screening and genetic services were provided in 13 public health centers and federally qualifed health centers. Staff received training on genetics and risk assessment using the Breast Cancer Genetics Referral Screening Tool (B-RST). Providers and medical residents were surveyed on their knowledge of HBOC. Young women with breast cancer were surveyed on receipt of genetic services. Results: More than 5,400 women were successfully screened; 79% identifed as racial/ethnic minorities. 5% of women screened positive on the B-RST, which is consistent with HBOC prevalence; 79% agreed to follow up. 23% met criteria for increased risk of BRCA 1/2 mutation and received genetic counseling and testing. Surveys revealed profound gaps in knowledge among physicians and medical residents and lack of delivery of evidence-based genetic services to survivors. Conclusions: The genomics project demonstrated the effcacy of population-based screening to identify high-risk women before they receive a diagnosis of cancer. A high percentage of women who screened positive also completed genetic counseling and testing. Access to the benefts of HBOC management to prevent cancer and decrease mortality among minority and underserved women depends on improvements in knowledge of genetics and evidence-based practice by providers. |
Pregnancy-associated homicide and suicide in 37 US states with enhanced pregnancy surveillance
Wallace ME , Hoyert D , Williams C , Mendola P . Am J Obstet Gynecol 2016 215 (3) 364.e1-364.e10 BACKGROUND: Pregnant and postpartum women may be at increased risk of violent death including homicide and suicide relative to nonpregnant women, but US national data have not been reported since the implementation of enhanced mortality surveillance. OBJECTIVE: The objective of the study was to estimate homicide and suicide ratios among women who are pregnant or postpartum and to compare their risk of violent death with nonpregnant/nonpostpartum women. STUDY DESIGN: Death certificates (n = 465,097) from US states with enhanced pregnancy mortality surveillance from 2005 through 2010 were used to compare mortality among 4 groups of women aged 10-54 years: pregnant, early postpartum (pregnant within 42 days of death), late postpartum (pregnant within 43 days to 1 year of death), and nonpregnant/nonpostpartum. We estimated pregnancy-associated mortality ratios and compared with nonpregnant/nonpostpartum mortality ratios to identify differences in risk after adjusting for potential levels of pregnancy misclassification as reported in the literature. RESULTS: Pregnancy-associated homicide victims were most frequently young, black, and undereducated, whereas pregnancy-associated suicide occurred most frequently among older white women. After adjustments, pregnancy-associated homicide risk ranged from 2.2 to 6.2 per 100,000 live births, depending on the degree of misclassification estimated, compared with 2.5-2.6 per 100,000 nonpregnant/nonpostpartum women aged 10-54 years. Pregnancy-associated suicide risk ranged from 1.6-4.5 per 100,000 live births after adjustments compared with 5.3-5.5 per 100,000 women aged 10-54 years among nonpregnant/nonpostpartum women. Assuming the most conservative published estimate of misclassification, the risk of homicide among pregnant/postpartum women was 1.84 times that of nonpregnant/nonpostpartum women (95% confidence interval, 1.71-1.98), whereas risk of suicide was decreased (relative risk, 0.62, 95% confidence interval, 0.57-0.68). CONCLUSION: Pregnancy and postpartum appear to be times of increased risk for homicide and decreased risk for suicide among women in the United States. |
Reporting of birth defects in SART CORS: Time to rely on data linkage
Mendola P , Gilboa SM . Fertil Steril 2016 106 (3) 554-5 In this issue of Fertility and Sterility, Stern et al. (1) assessed the validity of the birth outcome data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) compared with the outcome data from vital records and the Massachusetts Birth Defects Monitoring Program (BDMP), the statewide population-based active birth defects surveillance system for a cohort of 9,092 assisted reproductive technology (ART) deliveries from 2004 to 2008 in Massachusetts. Compared with vital records, the SART CORS does a great job of reporting for some outcomes, with >99% concordance on delivery outcome (live birth/fetal death) and plurality. More than 90% of birth dates match, and most singleton birth weights (87%) are different by <50 g. Maternal race/ethnicity is missing two-thirds of the time in SART CORS, but when not missing, it is reasonably accurate, with 95% concordance. So far, so good. When we look at birth defects, it is entirely another matter. | The SART CORS reported 135 birth defects among 132 infants compared with 184 birth defects among 132 infants in the BDMP data. Although it seems at first glance that we might still be on fairly solid ground with the same number of infants identified; the problem was that only 51 infants were identified with birth defects in both datasets. Overall, SART CORS is missing 81 infants (61%) that have birth defects confirmed by BDMP, and a corresponding 81 cases in the SART CORS are unconfirmed by BDMP. Compared with the active surveillance of the BDMP as the criterion standard, ART clinics appear to be missing the mark. The problem starts with the categories of birth defects reported in SART CORS; rather than capturing diagnostic codes or detailed information, the system allows for the following predefined categories, with no instruction provided as to which specific diagnoses are to be considered as relevant to a given category: none, unknown, cleft palate, genetic defect, limb defect, cardiac defect, and other. Given these limited and undefined categories, and that the SART CORS data come from a variety of reporting sources, including medical records, provider reports and parent self-reports, it is not surprising that there are inaccuracies. We were a bit surprised to see that the errors went in both directions, with similar numbers of false positives and false negatives. |
Concentrations of environmental phenols and parabens in milk, urine and serum of lactating North Carolina women
Hines EP , Mendola P , vonEhrenstein OS , Ye X , Calafat AM , Fenton SE . Reprod Toxicol 2014 54 120-8 Phenols and parabens show some evidence for endocrine disruption in laboratory animals. The goal of the Methods Advancement for Milk Analysis (MAMA) Study was to develop or adapt methods to measure parabens (methyl, ethyl, butyl, propyl) and phenols (bisphenol A (BPA), 2,4- and 2,5-dichlorophenol, benzophenone-3, triclosan) in urine, milk and serum twice during lactation, to compare concentrations across matrices and with endogenous biomarkers among 34 North Carolina women. These non-persistent chemicals were detected in most urine samples (53-100%) and less frequently in milk or serum; concentrations differed by matrix. Although urinary parabens, triclosan and dichlorophenols concentrations correlated significantly at two time points, those of BPA and benzophenone-3 did not, suggesting considerable variability in those exposures. These pilot data suggest that nursing mothers are exposed to phenols and parabens; urine is the best measurement matrix; and correlations between chemical and endogenous immune-related biomarkers merit further investigation. |
Allostatic load may not be associated with chronic stress in pregnant women, NHANES 1999-2006
Morrison S , Shenassa ED , Mendola P , Wu T , Schoendorf K . Ann Epidemiol 2013 23 (5) 294-7 PURPOSE: Pregnant women are generally excluded from studies that measure allostatic load (AL) because there is concern that the changing levels of AL-related biomarkers during pregnancy do not reflect a woman's true AL. The goal of this study was to determine whether AL can be measured in a meaningful way during pregnancy. METHODS: The National Health and Nutrition Examination Survey (NHANES) is a nationally representative, cross-sectional survey of the U.S. civilian population. AL was based on the distributions of 10 biomarkers in pregnant (n=1138) and nonpregnant (n=4993) women aged 15 to 44 from NHANES (1999-2006). RESULTS: The distribution of each AL-related biomarker differed significantly between pregnant and nonpregnant women (P<.01). Among nonpregnant women, high AL findings were consistent with previous studies (e.g., higher AL in women who are black, are older, and who have lower incomes). However, these associations were not seen in pregnant women. CONCLUSIONS: Our results suggest that the various biomarkers that comprise AL may reflect proximal factors in pregnancy more strongly than they represent exposure to chronic stress over a woman's lifetime. Therefore, our approach to measuring AL may not provide meaningful information about chronic stress in pregnant women without further consideration of pregnancy-related factors. |
National trends in emergency department use of urinalysis, complete blood count, and blood culture for fever without a source among children aged 2 to 24 months in the pneumococcal conjugate vaccine 7 era
Simon AE , Lukacs SL , Mendola P . Pediatr Emerg Care 2013 29 (5) 560-7 OBJECTIVES: The epidemiology of serious bacterial infections in children has changed since the introduction of the pneumococcal conjugate vaccine (PCV-7) in 2000. Whether emergency department (ED) physicians have changed diagnostic approaches to fever without a source (FWS) in response is unknown. We examine trends in rates of complete blood count (CBC), urinalysis (UA), and blood cultures among 2- to 24-month-old children with FWS since the introduction of PCV-7. METHODS: The National Hospital Ambulatory Medical Care Survey-Emergency Department, 2001-2009, was used to identify visits to the ED by 2- to 24-month-old children with FWS. Rates of CBC, UA, neither CBC nor UA, and blood culture were tracked across time. Trends were identified using Joinpoint regression and bivariate and multivariate logistic regressions with year as the independent variables and ordering of each test as dependent variables. RESULTS: In bivariate and multivariate analyses, CBC orders declined between 2004 and 2009 for visits by all children 2 to 24 months, children 2 to 11 months, and boys 2 to 24 months (adjusted odds ratio [aOR], 0.88 per year [P < 0.01]; aOR, 0.88 [P < 0.05]; and aOR, 0.83 [P < 0.01], respectively). Between 2004 and 2009, ordering neither CBC nor UA increased among all children 2 to 24 months (aOR, 1.10; P < 0.05) and among boys (aOR, 1.16; P < 0.05). Orders for blood cultures declined across the time period in bivariate analysis, but not in multivariate analysis. CONCLUSIONS: The rate of ordering a CBC for children in the 2- to 24-month age group presenting to the ED with FWS declined, a change coincident with the changing epidemiology of serious bacterial infection since the PCV-7 vaccine was introduced. |
Menopause and lead body burden among US women aged 45-55, NHANES 1999-2010
Mendola P , Brett K , Dibari JN , Pollack AZ , Tandon R , Shenassa ED . Environ Res 2013 121 110-3 BACKGROUND: Environmental factors in menopause have received limited attention. Lead is a known reproductive toxicant associated with delayed puberty in girls that may also affect menopause. METHODS: The odds of menopause among US women aged 45-55 were estimated in the National Health and Nutrition Examination Survey, 1999-2010, in relation to quartiles of blood lead. Women still menstruating (n=2158) were compared to women with natural menopause (n=1063). Logistic regression models included age, race/ethnicity, current hormone use, poverty, smoking and where available, bone density or bone alkaline phosphatase. RESULTS: Lead levels (ug/dL) were higher in menopausal women, geometric mean (standard error)=1.71 (0.04) vs. 1.23 (0.02). Adjusted odds of menopause and 95% confidence intervals for lead quartiles (lowest quartile referent) were 1.7 (1.0-2.8), 2.1 (1.2-3.6), and 4.2 (2.5-7.0) respectively. Results adjusting for bone markers were generally similar but had less precision. CONCLUSIONS: Blood lead was associated with natural menopause in US women even after adjustment for bone turnover. This raises concern that lead exposure, even at low levels, may shorten women's reproductive lifespan. |
The association between major depressive disorder and obesity in US adolescents: results from the 2001-2004 National Health and Nutrition Examination Survey
Merikangas AK , Mendola P , Pastor PN , Reuben CA , Cleary SD . J Behav Med 2012 35 (2) 149-54 The association between major depressive disorder (MDD) and obesity was assessed in 4,150 US adolescents aged 12-19 years from the 2001-2004 National Health and Nutrition Examination Survey. Weight and height were measured by health professionals and MDD was based on a structured diagnostic interview. The prevalence of MDD in the past year among US adolescents was 3.2% and 16.8% of US adolescents were obese. After adjustment for sex, age, race/ethnicity and poverty, MDD was not significantly associated with obesity among adolescents overall (adjusted odds ratio (adjOR) = 1.6, 95% confidence interval (CI) = 0.9-2.9), but an increased odds of obesity was observed among males (adjOR = 2.7, 95% CI = 1.1-7.1) and non-Hispanic blacks (adjOR = 3.1, 95% CI = 1.1-8.3) with MDD. Future research on strategies that might reduce the risk of obesity in males and non-Hispanic black adolescents with MDD may be warranted. |
Emergency department laboratory evaluations of fever without source in children aged 3 to 36 months
Simon AE , Lukacs SL , Mendola P . Pediatrics 2011 128 (6) e1368-75 OBJECTIVE: This article describes ordering of diagnostic tests, admission rates, and antibiotic administration among visits to US emergency departments (EDs) by children aged 3 to 36 months with fever without source (FWS). METHODS: The 2006-2008 National Hospital Ambulatory Medical Care Survey-Emergency Department was used to identify visits by 3- to 36-month-old children with FWS. Percentages of visits that included a complete blood count (CBC), urinalysis, blood culture, radiograph, rapid influenza test, admission to hospital, and ceftriaxone and other antibiotic administration were calculated. Multivariate logistic regression was used to identify factors associated with ordering of a CBC and urinalysis. RESULTS: No tests were ordered in 58.6% of visits for FWS. CBCs were ordered in 20.5% of visits and urinalysis in 17.4% of visits. Even among girls with a temperature of ≥39 degrees C, urinalysis was ordered in only 40.2% of visits. Ceftriaxone was given in 7.1% and other antibiotics in 18.3% of visits; 5.2% of the children at these visits were admitted to the hospital. In multivariate analysis, increased temperature, being female, and higher median income of the patient's zip code were associated with increased odds of having a CBC and urinalysis ordered. Being 24 to 36 months of age was associated with lower odds of receiving both a CBC and a urinalysis. CONCLUSIONS: Most US emergency department visits for FWS among children aged 3 to 36 months, physicians do not order diagnostic tests. Being female, having a higher fever, and higher median income of the patient's zip code were associated with ordering CBCs and urinalysis. |
Previous breastfeeding practices and duration of exclusive breastfeeding in the United States
Phillips G , Brett K , Mendola P . Matern Child Health J 2011 15 (8) 1210-6 We examined the influence of duration of exclusive breastfeeding (DEBF) for a mother's earlier children on the DEBF for her later children among multiparous women from the 2002 National Survey of Family Growth. DEBF was categorized as: never breastfed (NBF) (referent); not exclusively breastfed or exclusively breastfed for <4 months (EBF < 4); and exclusively breastfed for ≥4 months (EBF ≥ 4). We examined DEBF using weighted percentages and odds ratios (OR) with 95% confidence intervals (CI) from multinomial logistic regression models, adjusting for maternal factors. About 70% of multiparous women (n = 2,149) repeated the duration of exclusive breastfeeding of their first child for their second child; 14% of women repeated EBF ≥ 4. Among multiparous women, the adjusted odds ratio for EBF ≥ 4 for second children was 7.2 (95% CI = 4.0-12.9) when first children were EBF < 4 and 90.7 (95% CI = 45.4-181.4) when first children were EBF ≥ 4, relative to NBF first children. In analyses where DEBF of third children was the outcome, odds of EBF ≥ 4 were more strongly influenced by DEBF of second children while the impact of DEBF of first children was not as strong. Older maternal age and being married were related to an increased DEBF. Being married at second birth predicted a change from NBF for first children to EBF ≥ 4 for second children (OR = 6.2, 95% CI = 2.7-14.2). In conclusion, mothers generally repeated the DEBF of their previous child. For third children, DEBF of the second child was more likely to be repeated than that of the first child. |
Blood lead and mercury levels in pregnant women in the United States, 2003-2008
Jones L , Parker JD , Mendola P . NCHS Data Brief 2010 (52) 1-8 KEY FINDINGS: Data from the National Health and Nutrition Examination Survey, 2003-2008 In general, U.S. pregnant women have low levels of lead (less than 5 microg/dL) in their blood. Pregnant women have lower mercury and lead levels than nonpregnant women. Among pregnant women, mercury levels, but not lead levels, increase with age. Pregnant women with a prior pregnancy have lower mercury levels and higher lead levels than those without a prior pregnancy. Mexico-born Mexican-American pregnant women have higher lead levels than their U.S.-born counterparts, but similar mercury levels. |
Perinatal outcomes for Asian, Native Hawaiian, and other Pacific Islander mothers of single and multiple race/ethnicity: California and Hawaii, 2003-2005
Schempf AH , Mendola P , Hamilton BE , Hayes DK , Makuc DM . Am J Public Health 2010 100 (5) 877-87 OBJECTIVES: We examined characteristics and birth outcomes of Asian/Pacific Islander (API) mothers to determine whether differences in outcomes existed between mothers of single race/ethnicity and multiple race/ethnicity. METHODS: We used data from California and Hawaii birth certificates from 2003 through 2005 to describe variation in birth outcomes for API subgroups by self-reported maternal race/ethnicity (single versus multiple race or API subgroup), and we also compared these outcomes to those of non-Hispanic White women. RESULTS: Low birthweight (LBW) and preterm birth (PTB) varied more among API subgroups than between mothers of single versus multiple race/ethnicity. After adjustment for sociodemographic and behavioral risk factors, API mothers of multiple race/ethnicity had outcomes similar to mothers of single race/ethnicity, with exceptions for multiple race/ethnicity-Chinese (higher PTB), Filipino (lower LBW and PTB), and Thai (higher LBW) subgroups. Compared with single-race non-Hispanic Whites, adverse outcomes were elevated for most API subgroups: only single-race/ethnicity Korean mothers had lower rates of both LBW (3.4%) and PTB (5.6%); single-race/ethnicity Cambodian, Laotian, and Marshallese mothers had the highest rates of both LBW (8.8%, 9.2%, and 8.4%, respectively) and PTB (14.0%, 13.7%, and 18.8%, respectively). CONCLUSIONS: Strategies to improve birth outcomes for API mothers should consider variations in risk by API subgroup and multiple race/ethnicity. |
Participation in activities outside of school hours in relation to problem behavior and social skills in middle childhood
Howie LD , Lukacs SL , Pastor PN , Reuben CA , Mendola P . J Sch Health 2010 80 (3) 119-25 BACKGROUND: Research has shown that participating in activities outside of school hours is associated with lower dropout rates, enhanced school performance, improved social skills, and reduced problem behaviors. However, most prior studies have been limited to small populations of older children (>12 years). This analysis focuses on children aged 6 to 11 to assess the potential association between participation in activities outside of school hours and behavior in middle childhood in a nationally representative survey. METHODS: Estimates were based on 25,797 children from the 2003-2004 National Survey of Children's Health. Outside of school activity was defined as participating in sports teams/lessons, clubs/organizations, or both at least once in the past year. Analysis of variance was used to evaluate the differences in behavior problems and social skills adjusting for sociodemographic factors, among children classified by participation in outside of school activities. RESULTS: Seventy-five percent of children participated in outside of school activities: 23% in sports, 16% in clubs, and 36% in both clubs and sports. Activity participation differed by gender, race/ethnicity, type of school, poverty status, family structure, household education, and school and community safety. Children participating in both sports and clubs had higher social skills index scores, but no significant difference in problem behavior scores compared with children who did not participate in any outside of school activity. CONCLUSION: Children participating in both sports and clubs had greater social competence during middle childhood compared with children who did not participate in any outside of school activities. |
Urban-rural residence and the occurrence of cleft lip and cleft palate in Texas, 1999-2003
Messer LC , Luben TJ , Mendola P , Carozza SE , Horel SA , Langlois PH . Ann Epidemiol 2010 20 (1) 32-9 PURPOSE: The etiology of orofacial clefts is complex and relatively unknown. Variation in cleft lip with or without palate (CLP) and cleft palate alone (CP) was examined in Texas across urban-rural residence (1999 to 2003). METHODS: Cases came from the Texas Birth Defects Registry (1,949 CLP and 1,054 CP) and denominator data came from vital records (254 counties; 1,827,317 live births). Variation in maternal residence was measured using four classification schemes: Rural Urban Continuum Codes, Urban Influence Codes, percentage of county in cropland, and Rural Urban Commuting Areas. Poisson regression was used to calculate rate ratios, adjusted for infant sex, plurality, gestational age, maternal parity, age, race/ethnicity, and education. RESULTS: Compared to the most urban referent category, living in more rural areas was associated with an increased adjusted risk of CLP. For example, the Rural-Urban Continuum Codes demonstrated elevated risks for CLP in "thinly populated areas" compared to "metropolitan-urban areas" (adjusted prevalence ratio = 1.9; 95% confidence intervals (CI) 1.2-2.8); CP was not similarly associated. Percentage of county cropland was not consistently associated with any outcome. CONCLUSION: The association patterns between non-urban residence and risk of CLP, except for percentage of cropland, suggests a constellation of exposures that may differ across urban-rural residence. |
Prenatal smoking cessation and the risk of delivering preterm and small-for-gestational-age newborns
Polakowski LL , Akinbami LJ , Mendola P . Obstet Gynecol 2009 114 318-325 OBJECTIVE: To examine the association between prenatal smoking cessation and delivery of a preterm or small-for-gestational-age (SGA) newborn in a large U.S. subpopulation using the revised (2003) birth certificate, which now assesses maternal smoking status by trimester. METHODS: We analyzed a cohort of U.S.-resident, singleton births in the 11 states that used the revised birth certificate in 2005 (n=915,441). Self-reported maternal smoking status was categorized as "never smoked," "quit in the first trimester," "quit in the second trimester," and "smoked throughout" pregnancy (referent). Multinomial logistic regression was used to estimate adjusted odds ratios (aORs) for three outcomes (preterm non-SGA, term SGA, or preterm SGA newborns) by maternal smoking status. Analyses stratified by maternal age were also conducted. RESULTS: Compared with women who smoked throughout pregnancy, first-trimester quitters reduced their odds of delivering a preterm non-SGA newborn by 31% (aOR 0.69, 95% confidence interval [CI] 0.65-0.74), a term SGA newborn by 55% (aOR 0.45, 95% CI 0.42-0.48), and a preterm SGA newborn by 53% (aOR 0.47, 95% CI 0.40-0.55), similar to nonsmokers. Second-trimester quitters also reduced their odds of delivering preterm non-SGA and term SGA newborns but to a lesser magnitude. When comparing first-trimester quitters with smokers in each age group, older mothers had generally lower odds of these outcomes than younger mothers. CONCLUSIONS: Pregnant smokers who quit in the first trimester lowered their risk of delivering preterm and SGA newborns to a level similar to that of pregnant nonsmokers, and this benefit appeared to increase with maternal age. These findings reinforce current clinical guidance to encourage smoking cessation among pregnant smokers and serve as an additional incentive to quit. LEVEL OF EVIDENCE: II. |
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