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Aim: To evaluate the risk of urinary tract infections (UTI) in subjects with newly diagnosed type 2 diabetes mellitus (T2DM)., Methods: Subjects aged ≥18years and diagnosed with T2DM between 1/1/10 and 12/31/10 were identified using the MarketScan® databases, which are representative of the commercially insured US population and those with both Medicare and supplemental coverage. The index date was the first T2DM diagnosis date in 2010 (date randomly selected for those without T2DM). Subjects without T2DM were matched (1:1) by index date, age, gender, urban/rural location, and region. All subjects had continuous enrollment for 12 months before (baseline) and after (follow-up) the index date. UTI diagnosis was defined using ICD-9-CM codes. Measurements of glycemic control and body weight were not available. An adjusted logistic regression model assessed the likelihood of UTI., Results: A total of 89,790 matched pairs were selected. During follow-up, a UTI diagnosis was more common in subjects with T2DM than without T2DM (9.4% vs. 5.7%; p<0.0001). Recurrence of UTI was also more likely with T2DM (1.6% vs. 0.6%; p<0.0001). In a logistic regression, subjects with T2DM had a greater likelihood of UTI during follow up (adjusted odds ratio [OR]=1.54 [95% CI: 1.47-1.60]). This relationship remained after stratifying by gender., Conclusion: Subjects with T2DM were more likely to experience a UTI and recurrent UTIs than subjects without T2DM during follow-up., (Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.)

Aims: Type 2 diabetes is a reported risk factor for more frequent and severe urinary tract infections (UTI). We sought to quantify the annual healthcare cost burden of UTI in type 2 diabetic patients., Methods: Adult patients diagnosed with type 2 diabetes were identified in MarketScan administrative claims data. UTI occurrence and costs were assessed during a 1-year period. We examined UTI-related visit and antibiotic costs among patients diagnosed with UTI, comparing those with versus without a history of UTI in the previous year (prevalent vs. incident UTI cases). We estimated the total incremental cost of UTI by comparing all-cause healthcare costs in patients with versus without UTI, using propensity score-matched samples., Results: Within the year, 8.2% (6,014/73,151) of subjects had ≥1 UTI, of whom 33.8% had a history of UTI. UTI-related costs among prevalent versus incident cases were, respectively, $603 versus $447 (p=0.033) for outpatient services, $1,607 versus $1,819 (p=NS) for hospitalizations, and $61 versus $35 (p<0.0001) for antibiotics. UTI was associated with a total all-cause incremental cost of $7,045 (95% CI: 4,130, 13,051) per patient with UTI per year., Conclusions: UTI is common and may impose a substantial direct medical cost burden among patients with type 2 diabetes., (Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.)

Approximately 3.2 million people in the United States have chronic hepatitis C virus (HCV) infection; the primary cause for adult liver transplantation and a significant burden on healthcare resources. The role of HCV and other risk factors in development of HCC in patients with chronic kidney disease is not well defined. We studied predictors of hepatocellular carcinoma (HCC) in dialysis patients with chronic HCV by analyzing factors associated with its development. Data were extracted from the United States Renal Database System (USRDS) using ICD-9 codes. Variables included were gender, race, duration on dialysis and co-morbidities (alcohol abuse, drug abuse, HIV, hepatitis B, diabetes and/or presence of cirrhosis). Among the 32 806 HCV infected subjects, 262 cases had HCC. HCC was 12 times more likely in subjects with cirrhosis (P < 0.001), three times more likely in subjects with alcohol abuse (P < 0.001), and 1.3 times more likely in subjects with diabetes (P = 0.04). Asians were three times more likely (P < 0.001) to have HCC. Females were less likely to have HCC compared to males (P = 0.002). The likelihood of having HCC increased with age (P =0.001). This population-based study demonstrates that among subjects with HCV on dialysis, those with cirrhosis, Asian race and history of alcohol abuse are at highest risk for development of HCC. Furthermore, these findings indicate links between HCV and HCC which are valuable in case management for identifying; monitoring, and managing dialysis patients with HCC.

Objective: Most sub-Saharan African countries have fewer psychiatrists than one per one million people. One possible reason could be that medical students have a negative attitude toward the specialty. The authors evaluated the attitudes toward a career in psychiatry of final-year medical students in Kumasi, Ghana, and compare these with attitudes of medical students in Spain and the United States., Methods: Medical students were given a 28-item questionnaire on attitudes toward psychiatry, which was used in previous studies in Spain and the United States., Results: Ghanaian students (N=94) had a fairly positive view of psychiatry, similar to those in Spain, although less positive than U.S. students. About 15% were considering psychiatry as a career option. There was evidence of significant stigmatization of patients with mental illness and psychiatrists and concern about the use of coercive detention of patients., Conclusion: The difficulty recruiting physicians into psychiatry in Ghana, and perhaps other African countries, is unlikely to be due to negative attitudes and may be due to a lack of opportunity to train in psychiatry.

The Open Biomedical Ontologies (OBO) Foundry is a coordinated community-wide effort to develop ontologies that support the annotation and integration of scientific data. In work supported by the National Database of Autism Research (NDAR), we are developing an ontology of autism that extends the ontologies available in the OBO Foundry. We undertook a systematic literature review to identify domain terms and relationships relevant to autism phenotypes. To enable user queries and inferences about such phenotypes using data in the NDAR repository, we augmented the domain ontology with an information model. In this paper, we show how our approach, using a combination of description logic and rule-based reasoning, enables high-level phenotypic abstractions to be inferred from subject-specific data. Our integrated domain ontologyinformation model approach allows scientific data repositories to be augmented with rule-based abstractions that facilitate the ability of researchers to undertake data analysis.