Impact of Economic Recession on Cardiovascular Health Across 30 Major American Cities

Background: The economic recession from 2007 to 2009 created great fiscal challenges for American cities that have made them slow to recover. Economic instability causes increased unemployment rates forcing many to opt for compromised unhealthy lifestyles and increased mental stress. Therefore, the impact of economic recession on population's health has become a major concern. Objective: To study the impact of economic recession on cardiovascular disease (CVD) among urban population aged 18 years and older in 30 major cities in United States. Methods: The study with an ecological design was conducted using data from 2006-2012 Behavioral Risk Factor Surveillance System (BRFSS). Thirty largest cities by population were included in the analysis. Participants' health conditions including prevalence of CVD were defined on the basis of self-reported physician-diagnosis of disease. Differences in CVD prevalence across the 30 cities and associations of CVD with socioeconomic and behavior risk factors were examined using univariate and multivariate analysis approaches. All analysis was conducted using SAS 9.3 software. Results: Among 997161 participants of the total study sample, the prevalence of coronary heart disease (CHD) and stroke was 8.6% and 4.2%.Increasing age was a significant predictor for both the cardiovascular disease. Males had increased odds of developing CVD than females. Native Americans/Alaskan Indians followed by Blacks and had greater odds for CVD. Detroit, St. Louis and San Antonio had highest prevalence of CVD, while San Francisco, Seattle and Minneapolis had the lowest. Age adjusted results showed increased prevalence during economic recession period in all cities. Per capita real GDP, cigarette smoking, diabetes, depression, obesity, education, employment and income were significantly associated with CVD. Conclusion: The study confirms that in addition to the study of well-established CVD risk factors, such as smoking and obesity, economic recession has a significant impact on cardiovascular health among urban population. Further studies are needed to test the potential mechanisms by which economic recession causes the risk of CVD.M.P.H., Public Health -- Drexel University, 201

Validation of the ISTH/SSC bleeding assessment tool for inherited platelet disorders: a communication from the Platelet Physiology SSC

Background: Careful assessment of bleeding history is the first step in the evaluation of patients with mild/moderate bleeding disorders, and the use of a bleeding assessment tool (BAT) is strongly encouraged. Although a few studies have assessed the utility of the ISTH-BAT in patients with inherited platelet function disorders (IPFD) none of them was sufficiently large to draw conclusions and/or included appropriate control groups. Objectives: The aim of the present study was to test the utility of the ISTH-BAT in a large cohort of patients with a well-defined diagnosis of inherited platelets disorder in comparison with two parallel cohorts, one of patients with type-1 von Willebrand disease (VWD-1) and one of healthy controls (HC). Patients/Methods: We enrolled 1098 subjects, 482 of whom had inherited platelet disorders (196 IPFD and 286 inherited platelet number disorders [IT]) from 17 countries. Results: IPFD patients had significantly higher bleeding score (BS; median 9) than VWD-1 patients (median 5), a higher number of hemorrhagic symptoms (4 versus 3), and higher percentage of patients with clinically relevant symptoms (score > 2). The ISTH-BAT showed excellent discrimination power between IPFD and HC (0.9 < area under the curve [AUC] < 1), moderate (0.7 < AUC < 0.9) between IPFD and VWD-1 and between IPFD and inherited thrombocytopenia (IT), while it was inaccurate (AUC ≤ 0.7) in discriminating IT from HC. Conclusions: The ISTH-BAT allows to efficiently discriminate IPFD from HC, while it has lower accuracy in distinguishing IPFD from VWD-1. Therefore, the ISTH-BAT appears useful for identifying subjects requiring laboratory evaluation for a suspected IPFD once VWD is preliminarily excluded.Fil: Gresele, Paolo. Università di Perugia; ItaliaFil: Orsini, Sara. Università di Perugia; ItaliaFil: Noris, Patrizia. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; Italia. Universita Degli Studi Di Pavia; ItaliaFil: Falcinelli, Emanuela. Università di Perugia; ItaliaFil: Alessi, Marie Christine. Centre For Cardiovascular And Nutrition Research; FranciaFil: Bury, Loredana. Università di Perugia; ItaliaFil: Borhany, Munira. No especifíca;Fil: Santoro, Cristina. Azienda Ospedaliera Universitaria Policlinico Umberto I; ItaliaFil: Glembotsky, Ana Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Cid, Ana Rosa. Hospital Universitario y Politecnico La Fe; EspañaFil: Tosetto, Alberto. No especifíca;Fil: De Candia, Erica. Fondazione Policlinico Agostino Gemelli; Italia. Università Cattolica del Sacro Cuore; ItaliaFil: Fontana, Pierre. University Hospitals of Geneva; SuizaFil: Guglielmini, Giuseppe. Università di Perugia; ItaliaFil: Pecci, Alessandro. Universita Degli Studi Di Pavia; ItaliaFil: Heller, Paula Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Rodorigo, Giuseppina. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; ItaliaFil: Lammle, Bernhard. Università di Perugia; ItaliaFil: Trinchero, Alice. Università di Perugia; ItaliaFil: Paolo, Radossi. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; ItaliaFil: Ferrari, Silvia. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; ItaliaFil: Rancitelli, Davide. Università di Perugia; ItaliaFil: Stolinski, Amy. Università di Perugia; ItaliaFil: Arulselvan, Abinaya. Università di Perugia; ItaliaFil: Lassandro, Giuseppe. Università di Perugia; ItaliaFil: Sánchez Luceros, Analía Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Jandrot Perrus, Martine. Università di Perugia; ItaliaFil: Kunishima, Shinji. Università di Perugia; ItaliaFil: Rivera Pozo, José. Universidad de Murcia; EspañaFil: Lordkipanidzé, Marie. Università di Perugia; ItaliaFil: Melazzini, Federica. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; ItaliaFil: Falaise, Céline. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; ItaliaFil: Casonato, Alessandra. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; ItaliaFil: Podda, Gianmarco. Università di Perugia; ItaliaFil: Kannan, Meganathan. Università di Perugia; ItaliaFil: Jurk, Kerstin. Università di Perugia; ItaliaFil: Sevivas, Teresa. Università di Perugia; ItaliaFil: Castaman, Giancarlo. Universidad de Bologna; ItaliaFil: Grandone, Elvira. Università di Perugia; ItaliaFil: Fiore, Mathieu. Università di Perugia; ItaliaFil: Zuniga, Pamela. Università di Perugia; ItaliaFil: Henskens, Yvonne. Università di Perugia; ItaliaFil: Miyazaki, Koji. Università di Perugia; ItaliaFil: Dupuis, Arnaud. Università di Perugia; ItaliaFil: Hayward, Catherine. Università di Perugia; ItaliaFil: Zaninetti, Carlo. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; ItaliaFil: Abid, Madiha. Università di Perugia; ItaliaFil: Ferrara, Grazia. Università di Perugia; ItaliaFil: Mazzucconi, Maria Gabriella. Università di Perugia; ItaliaFil: Tagariello, Giuseppe. Università di Perugia; ItaliaFil: James, Paula. Università di Perugia; ItaliaFil: Fabris, Fabrizio. Universidad de Bologna; ItaliaFil: Russo, Alexandra. Università di Perugia; ItaliaFil: Bermejo, Nuria. Hospital de San Pedro de Alcantara, Cáceres; EspañaFil: Napolitano, Mariasanta. Università di Perugia; ItaliaFil: Curnow, Jennifer. Università di Perugia; ItaliaFil: Vasiliki, Gkalea. Università di Perugia; ItaliaFil: Zieger, Barbara. Università di Perugia; ItaliaFil: Fedor, Marian. Università di Perugia; ItaliaFil: Chitlur, Meera. Università di Perugia; ItaliaFil: Lambert, Michele. Università di Perugia; ItaliaFil: Barcella, Luca. Università di Perugia; ItaliaFil: Cosmi, Benilde. Università di Perugia; ItaliaFil: Giordano, Paola. Università di Perugia; ItaliaFil: Porri, Claudia. Università di Perugia; ItaliaFil: Eker, Ibrahim. Università di Perugia; ItaliaFil: Morel Kopp, Marie Christine. Università di Perugia; ItaliaFil: Deckmyn, Hans. Università di Perugia; ItaliaFil: Frelinger, Andrew L.. Università di Perugia; ItaliaFil: Harrison, Paul. Università di Perugia; ItaliaFil: Mezzano, Diego. Pontificia Universidad Católica de Chile; ChileFil: Mumford, Andrew D.. University of Bristol; Reino Unid