3 results on '"Keating, Claire"'
Search Results
2. Health Disparities among adults cared for at an urban cystic fibrosis program.
- Author
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DiMango E, Simpson K, Menten E, Keating C, Fan W, and Leu CS
- Subjects
- Adult, Child, Cross-Sectional Studies, Hispanic or Latino, Humans, Insurance Coverage, United States, White People, Cystic Fibrosis
- Abstract
Background: Evidence is conflicting regarding differential health outcomes in racial and ethnic minorities with cystic fibrosis (CF), a rare genetic disease affecting approximately 28,000 Americans. We performed a cross-sectional analysis of health outcomes in Black/Latinx patients compared with non-Hispanic Caucasian patients cared for in a CF center in New York City. Adult patients enrolled in the CF Foundation Patient Registry at the Columbia University Adult CF Program and seen at least once during 2019 were included. Health metrics were compared between Black/Latinx and non-Hispanic Caucasian patients., Results: 262 patients were eligible. 39 patients (15%) identified as Black/Latinx or non-Hispanic Caucasian. Descriptive statistics are reported with mean (standard deviation). Current age was 35.9 (13.3) years for non-Hispanic Caucasian and 32.0 (9.3) years for Black/Latinx patients (p = 0.087). Age of diagnosis did not differ between groups; 9.56 (15.96) years versus 11.59 (15.8) years for non-Hispanic Caucasian versus Black/Latinx respectively (p = 0.464). Pulmonary function, measured as mean forced expiratory volume in one second (FEV1) was 70.6 (22.5) percent predicted in non-Hispanic Caucasian versus 59.50 (27.9) percent predicted in Black/Latinx patients (p = 0.010). Number of visits to the CF clinic were similar between groups. When controlled for age, gender, co-morbidities, median income, and insurance status, there was a continued association between minority status and lower FEV1., Conclusions: Minorities with CF have significantly lower pulmonary function, the major marker of survival, than non-Hispanic Caucasians, even when controlled for a variety of demographic and socioeconomic factors that are known to affect health status in CF. Significant health disparities based on race and ethnicity exist at a single CF center in New York City, despite apparent similarities in access to guideline based care at an accredited CF Center. This data confirms the importance of design of culturally appropriate preventative and management strategies to better understand how to direct interventions to this vulnerable population with a rare disease., (© 2021. The Author(s).) more...
- Published
- 2021
- Full Text
- View/download PDF
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3. Cystic fibrosis is associated with an increased risk of Barrett's esophagus.
- Author
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Knotts RM, Solfisburg QS, Keating C, DiMango E, Lightdale CJ, and Abrams JA
- Subjects
- Adult, Age Factors, Cohort Studies, Early Diagnosis, Esophagoscopy methods, Esophagoscopy statistics & numerical data, Female, Humans, Long Term Adverse Effects diagnosis, Long Term Adverse Effects epidemiology, Male, Middle Aged, Patient Selection, Prevalence, Risk Assessment, Risk Factors, United States epidemiology, Adenocarcinoma epidemiology, Adenocarcinoma pathology, Barrett Esophagus epidemiology, Barrett Esophagus pathology, Cystic Fibrosis diagnosis, Cystic Fibrosis epidemiology, Cystic Fibrosis physiopathology, Esophageal Neoplasms epidemiology, Esophageal Neoplasms pathology, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux epidemiology
- Abstract
Background: Cystic fibrosis (CF) patients have increased risks of gastrointestinal cancers, including esophageal adenocarcinoma. Gastroesophageal reflux disease (GERD) is highly prevalent in CF and manifests at early ages. CF patients may be at increased risk for long-term sequelae of chronic GERD, including Barrett's esophagus (BE). We aimed to assess whether patients with CF have an increased risk of BE or related neoplasia., Methods: A matched cohort study was performed of adults with and without CF who had undergone upper endoscopy. Non-CF patients were matched in a 4:1 ratio by age, sex, year of exam, and endoscopist. Odds ratios were calculated for the association between CF and BE or related neoplasia, and multivariable logistic regression modeling was performed to adjust for matching variables and additional potential confounders., Results: 122 CF patients underwent endoscopy, and 488 matched controls were identified. Seven (5.7%) CF patients had BE or related neoplasia, including one GE junction adenocarcinoma. Mean age of affected CF patients was 36.0, and 85.7% had a prior solid organ transplant. The odds of BE was significantly increased in CF patients (OR 2.91, 95% CI 1.08-7.81). The risk remained significantly increased in a multivariable model including matching variables (OR 3.32, 95% CI 1.19-9.22) and in a parsimonious model (OR 2.99, 95% CI 1.06-8.42)., Conclusions: Adults with CF have a 3-fold increased risk of BE or related neoplasia and appears to develop at younger ages. Consideration should be given to screening for BE in select CF patients, especially those who have undergone solid organ transplantation., (Copyright © 2018. Published by Elsevier B.V.) more...
- Published
- 2019
- Full Text
- View/download PDF
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