Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Parker CS[original query] |
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Risk of venous thromboembolism occurrence among adults with selected autoimmune diseases: a study among a U.S. cohort of commercial insurance enrollees
Yusuf HR , Hooper WC , Grosse SD , Parker CS , Boulet SL , Ortel TL . Thromb Res 2015 135 (1) 50-7 OBJECTIVE: This study assessed the risk of venous thromboembolism (VTE) among privately insured adults in the U.S. with one or more of the following autoimmune diseases: autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). MATERIALS AND METHODS: Using the Truven Health MarketScan(R) Databases, patients 18-64 years of age with a diagnosis of AIHA, ITP, RA, or SLE in 2007 and a sex and age-group matched comparison group of enrollees were followed up through 2010 to identify VTE events. Survival curve and Cox proportional hazards analyses were conducted to assess differences between groups. RESULTS: Among patients with AIHA, ITP, RA, or SLE, or >1 of these diseases, the risk of at least one VTE event was 19.74, 7.72, 4.90, 9.89, and 13.35 per 1,000 person-years, respectively; among the comparison group, the risk was 1.91 per 1,000 person-years. The adjusted hazard ratios (aHRs) for VTE among patients with AIHA, ITP, RA, or SLE, or >1 of these diseases (when compared with the comparison group) tended to decline over follow-up time; at 1year, the aHRs were 6.30 (95% confidence interval [CI]: 4.44-8.94), 2.95 (95% CI: 2.18-4.00), 2.13 (95% CI: 1.89-2.40), 4.68 (95% CI: 4.10-5.33), and 5.11 (95% CI: 4.26-6.14), respectively. CONCLUSION: Having AIHA, ITP, RA, or SLE, or >1 of these diseases was associated with an increased likelihood of a VTE event. More research is necessary to develop better understanding of VTE occurrence among people with autoimmune diseases. |
Meeting the emerging public health needs of persons with blood disorders
Parker CS , Tsai J , Siddiqi AE , Atrash HK , Richardson LC . Am J Prev Med 2014 47 (5) 658-63 In its decades-long history, the Division of Blood Disorders (DBD) at CDC has evolved from a patient-focused, services-supporting entity at inception, to one of the world leaders in the practice of public health to improve the lives of people at risk for or affected by nonmalignant blood disorders. The DBD's earliest public health activities consisted of working with care providers in a network of hemophilia treatment centers to provide AIDS risk reduction services to people with hemophilia. Because this infectious disease threat has been reduced over time as a result of the development of safer treatment products, the DBD-under the auspices of congressional appropriations guidance-has expanded its core activities to encompass blood disorders other than hemophilia, including hemoglobinopathies such as thalassemia and sickle cell disease, and Diamond Blackfan anemia. Simultaneously, in transitioning to a greater public health role, the DBD has expanded its network of partners to new consumer and professional organizations, as well as state and other federal health agencies. The DBD has also developed and maintains many surveillance and registry activities beyond the Universal Data Collection system aimed at providing a better understanding of the health status, health needs, and health-related quality of life of people with nonmalignant blood disorders. The DBD has integrated applicable components of the Essential Services of Public Health successfully to promote and advance the agenda of blood disorders in public health. |
Blood disorders and public health
Richardson LC , Parker CS , Tsai J . Am J Prev Med 2014 47 (5) 656-7 Millions of people in the U.S. are affected by blood disorders.1 The accumulating epidemiologic evidence for non-malignant blood disorders continues to strengthen its consideration as a national public health priority. Although there is enormous potential for public health practice to reduce the disease burden and associated healthcare costs, the fiscal resources with which to do so are decreasing and may continue in the near future. Thus, the Division of Blood Disorders (DBD) at the Centers for Disease Control and Prevention (CDC) has embraced a new currency of developing and implementing a comprehensive set of public health approaches to effectively promote and improve the health of people with blood disorders. | In spite of having effective regimens to prevent blood clots, it is estimated that thousands of patients will die of a blood clot associated with a hospital stay.2 Hydroxyurea has been proven to result in fewer painful crises, fewer episodes of acute chest syndrome, fewer blood transfusions,3 and lower risk of death in adult sickle cell disease (SCD) patients,4 yet less than one third of the patients who might benefit from it actually receive it.5 Prophylactic treatment in hemophilia patients reduces the number of bleeds significantly as compared to on-demand treatment; however, this has not become a standard of care.6 These public health activities have been undertaken by DBD and seek to bring to bear proven interventions in areas where research and surveillance findings suggest that potential benefits might be realized and adverse effects might be mitigated. Additionally, these approaches attempt to develop and implement interventions that benefit the entire community of people affected by blood disorders. |
Sickle cell disease--the American saga
Siddiqi AE , Jordan LB , Parker CS . Ethn Dis 2013 23 (2) 245-8 The transformation of sickle cell disease (SCD) from obscurity in Africa to visibility in America over the past 100 years is intertwined with politics and race relations unique to America.1 Parallel to the development of a conventional scientific understanding of the disease and the evolution of disease control strategies, SCD also developed socio-politically. Initially thought to be a disease exclusively affecting a minority group, it was brought on the political agenda through concerted efforts made primarily by the community that identified closely with the people who suffered from it. The socio-political development that propelled investments in research into the disease’s origins, treatment, and models of care resulted in considerable improvements in life expectancy of people with SCD over the past nine decades.2 | In this article, we explore the timeline of scientific attention to SCD and the published literature, available from various online sources including the National Library of Medicine’s PubMed. In our online search, we used the key words and phrases: sickle cell disease history; history of sickle cell disease in United States; and prevalence of sickle cell disease. References found in retrieved articles and books provided additional sources of information aligned with our search. |
Sickle cell disease the need for a public health agenda
Yusuf HR , Lloyd-Puryear MA , Grant AM , Parker CS , Creary MS , Atrash HK . Am J Prev Med 2011 41 S376-83 Sickle cell disease (SCD) is a collection of inherited blood disorders that affect a substantial number of people in the U.S., particularly African Americans. People with SCD have an abnormal type of hemoglobin, Hb S, which polymerizes when deoxygenated, causing the red blood cells to become misshapen and rigid. Individuals with SCD are at higher risk of morbidity and mortality from infections, vaso-occlusive pain crises, acute chest syndrome, and other complications. Addressing the public health needs related to SCD is an important step toward improving outcomes and maintaining health for those affected by the disorder. The objective of this study was to review public health activities focusing on SCD and define the need to address it more comprehensively from a public health perspective. We found that there has been some progress in the development of SCD-related public health activities. Such activities include establishing newborn screening (NBS) for SCD with all states currently having universal NBS programs. However, additional areas needing focus include strengthening surveillance and monitoring of disease occurrence and health outcomes, enhancing adherence to health maintenance guidelines, increasing knowledge and awareness among those affected, and improving healthcare access and utilization. These and other activities discussed in this paper can help strengthen public health efforts to address SCD. |
Public health implications of sickle cell trait: a report of the CDC meeting
Grant AM , Parker CS , Jordan LB , Hulihan MM , Creary MS , Lloyd-Puryear MA , Goldsmith JC , Atrash HK . Am J Prev Med 2011 41 S435-9 Although the issue of whether sickle cell trait (SCT) is clinically benign or a significant health concern has not yet been resolved, the potential health risk to affected individuals is of vital importance and represents a tremendous challenge in protecting, promoting, and improving the health of the approximately 300 million people worldwide and 3 million people in the U.S. who possess the trait. In response to a request by the Sickle Cell Disease Association of America, in December 2009, the CDC convened a meeting of partners, stakeholders, and experts to identify the gaps in public health, clinical health services, epidemiologic research, and community-based outreach strategies and to develop an agenda for future initiatives. Through facilitated discussion and presentations in four topic areas, participants discussed pertinent issues, synthesized clinical research findings, and developed a coherent framework for establishing an agenda for future initiatives. A primary outcome of the meeting was to provide the first step of an iterative process to move toward agreement regarding appropriate counseling, care, and, potentially, treatment of people with SCT. |
Factors affecting the willingness of counselors to integrate preconception care into sexually transmitted disease clinics
Parker CS , Ghaddar S , Zhang Q , Cooke B . Womens Health Issues 2010 20 (5) 329-34 BACKGROUND: The high rate of unintended pregnancy is an immediate barrier to providing preconception care (PCC). Failure to deliver additional PCC messages at sexually transmitted disease (STD) clinics might represent a major missed opportunity to target women at increased risk for unintended pregnancy for behaviors that also put them at risk for adverse pregnancy outcomes. METHODS: Using a survey questionnaire, we assessed perceptions of PCC and factors influencing the willingness of STD counselors to integrate PCC as an intervention service provided by the STD clinics of 140 STD counselors. We used a cross-sectional design and selected survey participants with a minimum of 2 years' experience in providing HIV pretest and posttest counseling and syphilis interviewing using a nonprobability, purposive sample. RESULTS: The level of occupational responsibility and the amount of time available seemed to affect counselor perceptions of the importance of PCC and whether it should be integrated as an intervention service provided by STD clinics. Findings suggested that, although most STD counselors reported that PCC was an important issue, there was significant variation in the perception of whether PCC should be delivered at STD clinics. CONCLUSION: STD counselors perceived PCC to be an important intervention service that can be delivered at STD clinics. Additional study is needed to identify factors that might affect full integration into the STD clinic setting. |
Developing a public health research agenda for women with blood disorders
Byams VR , Beckman MG , Grant AM , Parker CS . J Womens Health (Larchmt) 2010 19 (7) 1231-4 Bleeding and clotting in women is an issue that directly affects the life of every woman, child, and family worldwide. This article summarizes recent activities undertaken by the Division of Blood Disorders (DBD) at the Centers for Disease Control and Prevention (CDC) to identify risk factors through evidence-based research and surveillance to prevent complications of blood disorders in women. Specific focus is given to our efforts to improve early identification and diagnosis of blood disorders among women, improve our understanding of maternal and infant outcomes, and develop surveillance systems to monitor the prevalence and incidence of these events. |
Assessing emerging infectious threats to blood safety for the blood disorders community
Trimble SR , Parker CS , Grant AM , Soucie JM , Reyes N . Am J Prev Med 2010 38 S468-74 Technologic advances in diagnostic testing, vaccinations, pathogen inactivation, and vigilant donor screening have greatly reduced the risk of transmitting pathogens through blood transfusion. Nevertheless, transfusion-related infections and fatalities continue to be reported, and emerging pathogens continue to become an increasing threat to the blood supply. This threat is even greater to patients with blood disorders, who are heavily transfused and rely on safe blood products. This article describes some of the emerging and re-emerging transfusion-transmitted pathogens that have increased in incidence in the U.S. in recent years. Peer-reviewed articles and agency websites were the sources of information. The article focuses on the treatment of hereditary blood disorders including hemophilia and thalassemia, and hereditary bone marrow failure. A coordinated approach to addressing blood safety and continued development of sensitive diagnostic testing are necessary to reduce risk in an increasingly globalized society. |
Burden of disease resulting from hemophilia in the U.S
Siddiqi AE , Ebrahim SH , Soucie JM , Parker CS , Atrash HK . Am J Prev Med 2010 38 S482-8 BACKGROUND: Hemophilia is a hereditary bleeding disorder. Its complications can result in substantial morbidity, but few efforts have been made to quantify the disease burden. PURPOSE: The objective of this analysis was to estimate the burden of disease due to hemophilia (A and B) in the U.S., using disability-adjusted life years (DALY). METHODS: The approach taken by the WHO in its Global Burden of Disease study was followed. Assumptions were drawn from published literature, and population estimates from the U.S. Census Bureau for the Year 2007 were used. Estimations of years of life lost resulting from mortality (YLL) and years of life lost resulting from morbidity (YLD) were done separately by gender, 5-year age intervals, and severity of disease (morbidity only) with their sum representing DALYs. Disability weights were derived from the quality-of-life tool EuroQol (EQ-5D). The stability of burden estimates was tested by performing sensitivity analyses, changing one assumption at a time. RESULTS: In the U.S. in 2007, hemophilia resulted in 110,095 DALYs, composed of 13,418 YLLs and 96,677 YLDs. Large differences between men/boys (107,346) and women/girls (2749) were observed, given that females are genetic carriers of the disorder and rarely present with disease. Sensitivity analyses revealed a relatively robust estimate with a maximum variation of 4.49%. CONCLUSIONS: This first estimate of hemophilia-related DALYs in the U.S. indicates that control of hemophilia can potentially result in a gain of 1 healthy year of life for every 2700 people in the population. |
The public health response to blood disorders
Atrash HK , Parker CS . Am J Prev Med 2010 38 S451-5 Nonmalignant blood disorders meet all criteria for qualifying, as a group, as a very important public health problem with serious morbidities affecting over 1 million Americans every year, not including an additional 8 million individuals suffering from anemia. Many of these conditions and the morbidities and mortalities associated with them are, to a large extent, preventable. Further, the changing demographic composition of the American population is sure to increase the number of individuals affected by these conditions. Yet, nonmalignant blood disorders have not been recognized as important public health priorities. Immediate action is needed to meet the increasing challenge of blood disorders in public health. We propose a national, comprehensive, organized, coordinated, institutionalized, sustainable public health response to blood disorders based on the three core functions and the ten essential services of public health. Immediate action needs to be taken to improve surveillance and monitoring, increase public and provider awareness, increase the use of evidence-based practices, and enhance epidemiologic research on the causes, prevention, and treatment of conditions resulting in adverse outcomes. |
Emergency department visits made by patients with sickle cell disease: a descriptive study, 1999-2007
Yusuf HR , Atrash HK , Grosse SD , Parker CS , Grant AM . Am J Prev Med 2010 38 S536-41 BACKGROUND: Patients with sickle cell disease (SCD) often use emergency department services to obtain medical care. Limited information is available about emergency department use among patients with SCD. PURPOSE: This study assessed characteristics of emergency department visits made nationally by patients with SCD. METHODS: Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for the years 1999-2007 were analyzed. The NHAMCS is a survey of hospital emergency department and outpatient visits. Emergency department visits by patients with SCD were identified using ICD-9-CM codes, and nationally weighted estimates were calculated. RESULTS: On average, approximately 197,333 emergency department visits were estimated to have occurred each year between 1999 and 2007 with SCD as one of the diagnoses listed. The expected source of payment was private insurance for 14%, Medicaid/State Children's Health Insurance Program for 58%, Medicare for 14%, and other/unknown for 15%. Approximately 29% of visits resulted in hospital admission; this was 37% among patients aged 0-19 years, and 26% among patients aged ≥20 years. The episode of care was indicated as a follow-up visit for 23% of the visits. Patient-cited reasons for the emergency department visit included chest pain (11%); other pain or unspecified pain (67%); fever/infection (6%); and shortness of breath/breathing problem/cough (5%), among other reasons. CONCLUSIONS: Substantial numbers of emergency department visits occur among people with SCD. The most common reason for the emergency department visits is pain symptoms. The findings of this study can help to improve health services delivery and utilization among patients with SCD. |
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