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Diverging mortality pathways for chronic wounds: A 26-year analysis of United States national data, 1999-2024.

BACKGROUND: Pressure ulcers (PUs) and chronic non-healing wounds (NHWs) are common, costly, and often fatal conditions among older adults living with multiple illnesses. Although the two arise through distinct biological pathways, they are frequently reported together in a way that can obscure how each is actually trending. We separated the two conditions and examined their mortality trajectories across 26 years of United States national data. METHODS: Using the CDC WONDER database, we retrospectively analyzed death records from 1999 through 2024. Pressure ulcers were identified by ICD-10 cod

Outcomes Among Medicare Beneficiaries After Cancer Surgery in Hospitals That Subsequently Closed.

IMPORTANCE: Hospital closures pose persistent concerns about health care access, yet the extent to which closures are associated with cancer surgical care and patient outcomes remains unknown. OBJECTIVE: To examine the association between undergoing colon or lung cancer surgery in hospitals that subsequently closed and postoperative and travel outcomes among Medicare beneficiaries. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used Medicare administrative data from 2008 to 2019. A national sample of hospital closures was identified using the Provider of Service files fro

Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care: A Randomized Clinical Trial.

IMPORTANCE: Depression is a common disorder that may go untreated or receive suboptimal care in primary care settings. Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression. OBJECTIVES: To evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers o

Equitability of Depression Screening After Implementation of General Adult Screening in Primary Care.

IMPORTANCE: Depression is a debilitating and costly medical condition that is often undertreated. Men, racial and ethnic minority individuals, older adults, and those with language barriers are at increased risk for undertreatment of depression. Disparities in screening may contribute to undertreatment. OBJECTIVE: To examine depression screening rates among populations at risk for undertreatment of depression during and after rollout of general screening. DESIGN, SETTING, AND PARTICIPANTS: This cohort study from September 1, 2017, to December 31, 2019, of electronic health record data from 5

Effect of Combination Treatment With Varenicline and Nicotine Patch on Smoking Cessation Among Smokers Who Drink Heavily: A Randomized Clinical Trial.

IMPORTANCE: The concurrent use of both tobacco and alcohol causes substantial disease and early mortality, and smokers who drink heavily tend to be less successful in smoking cessation than smokers who do not. Although varenicline combined with nicotine replacement therapy for smoking cessation has been examined among smokers who do not drink heavily, this combination treatment has not yet been examined among smokers who drink heavily. OBJECTIVE: To determine whether combined treatment with varenicline tartrate and nicotine patch improves continuous abstinence from cigarette smoking among smo

Asthma Surveillance - United States, 2006-2018.

PROBLEM: Asthma is a chronic disease of the airways that requires ongoing medical management. Socioeconomic and demographic factors as well as health care use might influence health patterns in urban and rural areas. Persons living in rural areas tend to have less access to health care and health resources and worse health outcomes. Characterizing asthma indicators (i.e., prevalence of current asthma, asthma attacks, emergency department and urgent care center [ED/UCC] visits, and asthma-associated deaths) and determining how asthma exacerbations and health care use vary across the United Stat

Subcutaneous blinatumomab in adults with relapsed or refractory B-cell acute lymphoblastic leukaemia: post-hoc safety and activity analysis from a multicentre, single-arm, phase 1/2 trial.

BACKGROUND: Two doses of subcutaneous blinatumomab in patients with relapsed or refractory B-cell acute lymphoblastic leukaemia were identified as preliminary recommended phase 2 doses, based on the dose-escalation phase of this multicentre single-arm, phase 1/2 trial. Here, we aim to further study the safety, activity, and pharmacokinetics of these doses in all participants who have received them, including those treated in the completed phase 1b expansion part of the study. METHODS: We did a post-hoc analysis of data from patients enrolled in the dose-escalation and dose-expansion phases an

Burden of liver cancer mortality by county, race, and ethnicity in the USA, 2000-19: a systematic analysis of health disparities.

BACKGROUND: Understanding how specific populations are affected by liver cancer is important for identifying priorities, policies, and interventions to mitigate health risks and reduce disparities. This study aims to provide comprehensive analysis of rates and trends in liver cancer mortality for different racial and ethnic populations in the USA nationally and at the county level from 2000 to 2019. METHODS: We applied small-area estimation methods to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to e

Clinical Actionability of Molecular Targets in Multi-Ethnic Breast Cancer Patients: A Retrospective Single-Institutional Study.

BACKGROUND: Precision oncology is making remarkable advancements in optimizing patient care by personalizing treatments. To date, the US Food and Drug Administration (FDA) has approved poly(ADP-ribose) polymerase inhibitors (PARPi) olaparib (Lynparza, AstraZeneca and Merck) and talazoparib (Talzenna, Pfizer Oncology Together™) for germline or somatic BRCA1/2-mutated metastatic breast cancer (BC) patients, and PI3K inhibitor alpelisib (Piqray, Novartis) plus fulvestrant for patients with hormone receptor-positive human epidermal growth factor receptor 2-negative (HR+HER2-) PIK3CA-mutated advanc

Surveillance for Violent Deaths - National Violent Death Reporting System, 42 States, the District of Columbia, and Puerto Rico, 2019.

PROBLEM/CONDITION: In 2019, approximately 67,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 42 states, the District of Columbia, and Puerto Rico in 2019. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics. PERIOD COVERED: 2019. DESCRIPTION OF SYSTEM: NVDRS collects data regarding violent deaths obtained from death certific

Regional, demographic and temporal trends in anemia and malignant cancer-related mortality in U.S. older adults: a nationwide CDC WONDER analysis (1999-2020).

PurposeAnemia and malignancy concurrently contribute to reduced quality of life, treatment intolerance, and increased morbidity and mortality, disproportionately affecting older adults, socioeconomically disadvantaged groups, and minority populations. Despite its clinical importance, national patterns and population-level disparities in the mortality burden associated with this comorbidity remain poorly characterized. This study aims to examine mortality trends associated with concurrent anemia and malignancy in the United States using CDC WONDER (Centers for Disease Control and Prevention Wid

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… or Alaska Native: 27.53, 95% CI: 25.91 to 29.15; Hispanic or Latino: 24.25, 95% CI: 23.85 to 24.64; NH Asian or Pacific Islander: 22.16, 95% CI: 21.64 to 22.68). … While we noted that estimates for smaller groups like NH American Indian or Alaska Natives may be unstable due to sample sizes, we must also acknowledge racial misclassification as a distinct source of bias. …

Patterns of injury mortality among Athabascan Indians in interior Alaska 1977-1987.

It was found that almost one-half of all Interior Alaska rural fatalities from thirty-six villages are due to unintentional and intentional injury. Drowning, motor vehicle crashes, hypothermia, fire, carbon monoxide poisoning and air transport crashes accounted for over 32% of all deaths; suicide and homicide account for over 15%. Many of these deaths are preventable.

Use of computerized prenatal interviews for assessing high-risk behaviors among American Indians.

The objectives of this study were to determine the prevalence of risk factors for adverse pregnancy outcomes among American Indians and to compare self-reported information collected under two computer interview conditions: an "anonymous" (N = 183) versus a "confidential" (N = 210) format. Results indicated that under 10% in both groups reported either use of cigarettes or other drugs of abuse, 16% reported risky drinking, 39% reported psychological distress, and 8% reported physical abuse during the current pregnancy. We concluded that confidential computer interviews were appropriate vehicle

Comparative study of problematic gambling behaviors between American Indian and non-Indian adults in a Northern Plains reservation.

This study compared the active gambling behaviors of American Indian adults, living on or near a reservation with those of non-Indian adults adjacent to or within the reservation. Results indicated that a variety of factors including economic status, unemployment, increased alcohol use, depression, historical trauma, and lack of social alternatives may predispose American Indian adults to greater problematic and pathological gambling behaviors. Unlike previous research that placed males at significantly greater risk for gambling problems, this study found that adult American Indian males and f

Planned Community Birth and Birth Outcomes.

IMPORTANCE: Studies examining community births (ie, births that occur outside of a hospital setting, such as at home or in a birth center) often misclassify transfers to hospitals as hospital births. Oregon uniquely tracks planned birth location at labor onset. OBJECTIVES: To examine the association between planned place of delivery and perinatal outcomes in Oregon. DESIGN, SETTING, AND PARTICIPANTS: This was a population-based cohort study of singleton, nonbreech infants without lethal anomalies born at 37 to 44 weeks' gestation in Oregon between January 2012 and December 2020. Data were an

The National Landscapes of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma: Stable Trends in Black Populations and Late-Stage Tumors.

BACKGROUND: Helicobacter pylori (H. Pylori) eradication has been the mainstream for preventing and treating gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Prior data showed disparities in eradication rates of H. Pylori between different populations. This can potentially impact the occurrence of gastric MALT lymphoma. There are limited data on the incidence and mortality rates and trends of gastric MALT lymphoma in the US. Therefore, the aim of the current study was to conduct a time-trend analysis of gastric MALT lymphoma incidence and mortality rates in different populations. MET

Sexual and reproductive health of persons aged 10-24 years - United States, 2002-2007.

This report presents data for 2002-2007 concerning the sexual and reproductive health of persons aged 10-24 years in the United States. Data were compiled from the National Vital Statistics System and multiple surveys and surveillance systems that monitor sexual and reproductive health outcomes into a single reference report that makes this information more easily accessible to policy makers, researchers, and program providers who are working to improve the reproductive health of young persons in the United States. The report addresses three primary topics: 1) current levels of risk behavior a

Long-term exposure to wildfire-related PM2·5 and overall survival of older patients with lung cancer: a retrospective, registry-based cohort study.

BACKGROUND: Fine particulate matter (PM2·5) has been identified as a key risk factor for lung cancer incidence and survival. PM2·5 from wildfire smoke is an increasingly important contributor to total PM2·5 in the USA, driven by climate change, and potentially more toxic than non-wildfire PM2·5 due to its smaller particle size and higher toxic contents. However, the effects of wildfire-related PM2·5 on the overall survival of patients with lung cancer remain unclear. METHODS: This retrospective cohort study included patients aged 65 years or older with histologically confirmed primary small-c

Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomised, double-blind, double placebo-controlled trial.

BACKGROUND: Baricitinib and dexamethasone have randomised trials supporting their use for the treatment of patients with COVID-19. We assessed the combination of baricitinib plus remdesivir versus dexamethasone plus remdesivir in preventing progression to mechanical ventilation or death in hospitalised patients with COVID-19. METHODS: In this randomised, double-blind, double placebo-controlled trial, patients were enrolled at 67 trial sites in the USA (60 sites), South Korea (two sites), Mexico (two sites), Singapore (two sites), and Japan (one site). Hospitalised adults (≥18 years) with COVI

Efficacy and safety of balovaptan for socialisation and communication difficulties in autistic adults in North America and Europe: a phase 3, randomised, placebo-controlled trial.

BACKGROUND: There are no approved pharmacological therapies to support treatment of the core communication and socialisation difficulties associated with autism spectrum disorder in adults. We aimed to assess the efficacy, safety, and pharmacokinetics of balovaptan, a vasopressin 1a receptor antagonist, versus placebo in autistic adults. METHODS: V1aduct was a phase 3, randomised, placebo-controlled, double-blind trial, conducted at 46 sites across six countries (the USA, the UK, France, Italy, Spain, and Canada). Eligible participants were aged 18 years or older with an intelligence quotient