Patients with human immunodeficiency virus (HIV) infection need lifelong medical care, but many do not remain in care. The effect of poor retention care on survival is known, and we sought to quantify that relationship.We conducted a retrospective cohort study involving persons newly identified as having HIV during 1997-1998 at any United States Department Veterans Affairs hospital or clinic who started antiretroviral therapy after 1 January 1997. To be included the study, patients had have...

Social support predicts adherence to antiretroviral therapy (ART) in some settings but has not been well studied persons newly diagnosed with HIV infection as a predictor of success through the cascade care. One hundred sixty-eight completed Medical Outcomes Study Support Survey at diagnosis, and 129 were successfully followed for more than 12 months. earlier diagnosis infection, linkage care, retention ART use by 1 year, ART. Higher social scores (either overall or on subscale) associated...

AbstractBackground: Poor retention in HIV care leads to poor survival. The predictors of are not well understood, especially from US nationwide datasets. We determined the among a group veterans and examined whether was confounded by other Methods: conducted retrospective cohort study 2,619 male who started antiretroviral therapy after January 1, 1998. defi ned as having had at least 1 quarter-year without any primary visit year starting therapy. Survival assessed through 2002. Logistic...

Background— Complex antithrombotic therapy (CAT) prescribed to elderly patients increases the risk of gastrointestinal bleeding. We quantified upper (UGIE) and lower (LGIE) events, transfusions, hospitalizations in a national cohort veterans CAT. Methods Results— Veterans ≥60 years age anticoagulant-antiplatelet, aspirin (ASA)-antiplatelet, ASA-anticoagulant, or triple (ie, TRIP, anticoagulant-antiplatelet-ASA) were identified from pharmacy database (October 1, 2002 September 30, 2008)....

Lack of trust by the patient in physicians or healthcare system has been associated with poorer health outcomes. The present study was designed to determine if and among persons newly diagnosed HIV infection predictive patients' subsequent linkage, retention, adherence care. 178 infected patients were administered trust-in-physicians trust-in-healthcare scales. Median scores compared for all mentioned Univariate logistic regression using trust-in-physician scale confirmed significant...

Purpose: To compare the performance of self-report instruments assessing adherence to antiretroviral therapy (ART) in patients starting ART for first time and a predominately Hispanic population.Methods: Of 184 prospective observational cohort study newly diagnosed, minority low socioeconomic status, 54 were given Medication Event Monitoring System (MEMS) caps their boosted protease inhibitor (PI) or non-nucleoside reverse transcriptase (NNRTI). They completed 4'week recall visual analogue...

Objective Little is known about the treatment outcomes of undocumented Hispanic immigrants with HIV infection. We sought to compare and documented patients 12-months after entering care. Methods conducted a retrospective cohort study antiretroviral-naive 18 years older attending their first visit at Thomas Street Health Center in Houston, Texas, between 1/1/2003 6/30/2008. The population 1,620 HIV-infected adults included 186 Hispanic, 278 986 Black, 170 White patients. main outcome measures...

Objective Geographic and racial disparities may contribute to variation in the incidence outcomes of HIV-associated cancers United States. Method Using Surveillance, Epidemiology, End Results (SEER) database, we analyzed Kaposi sarcoma (KS) survival by race geographic region during combined antiretroviral therapy era. Reported cases KS men from 2000 2013 were obtained 17 SEER cancer registries. Overall age-standardized rates calculated stratified region. We evaluated trends using joinpoint...

Recent studies have shown that the incidence of squamous cell cancer anus (SCCA) has increased in combined antiretroviral therapy (cART) era. The effect undetectable HIV viral loads as a result successful cART not been evaluated.We performed retrospective cohort study among male US veterans diagnosed with and followed between 1985 2009 using Veterans Affairs Immunologic Case Registry (VA-ICR). We calculated age-adjusted rates rate ratios for SCCA. conducted Cox proportional hazards SCCA...

Background. Few interventions have been shown to improve retention in human immunodeficiency virus (HIV) care, and none targeted the hospitalized patient. Peer mentoring has not rigorously tested. Methods. We conducted a randomized, controlled clinical trial of peer intervention. Eligible adults were either newly diagnosed with HIV infection or out care. The intervention included 2 in-person sessions volunteer mentor while hospitalized, followed by 5 phone calls 10 weeks after discharge....

Objectives: We sought to operationalize, test, and validate an outpatient pharmacy-based case-mix adjuster. Methods: Outpatients from the Department of Veterans Affairs (VA) prescribed a nonsteroidal anti-inflammatory drug (NSAID) or cyclooxygenase-2 selective during 2002 were identified. updated extended Rx-Risk-V by adding 26 additional disease categories mapping them VA drug-class codes; derived empirical weights for each logistic model 1-year mortality; adjusted age, race sex; scored...

Racial disparities in oropharyngeal squamous cell carcinoma (SCC) have been demonstrated and attributed to differences human papillomavirus (HPV) status. The purpose of this study was examine racial SCC among veterans.Retrospective review patients with at a tertiary-care Veterans Affairs (VA) hospital. Adjusted Cox proportional hazards models were conducted the effect race on outcomes.Of 158 patients, 126 (79.7%) white 32 (20.3%) African American. No difference p16 tumor expression noted...

Objectives The US Department of Veterans Affairs ( VA ) is the largest integrated health care provider for HIV ‐infected patients in A. data ‐specific clinical and quality improvement research are an important resource. We sought to determine accuracy using Corporate Data Warehouse CDW ), a fully automated medical records database all users nationally, identify compared with gold‐standard Clinical Case Registry CCR ). Methods assessed test performance characteristics each our criteria‐based...

To update information on workers in the petroleum industry engaged production of crude oil to determine whether patterns mortality have changed with 14 additional years follow up.All were employed at company and pipeline locations sometime during 1946-94. The cohort now consists 24 124 employees an average 22 up.The overall mortality, most cause specific mortalities lower than or similar those for general United States population. For white men (81% cohort), there 4361 observed deaths 5945...

OBJECTIVE: To examine patterns of mortality for specific causes death with increases in the Texaco study to determine if are related employment petroleum industry. METHODS: Mortality by duration various job groups were examined mesothelioma, non-Hodgkin's lymphoma, multiple myeloma, cell type leukaemia, and brain tumours. RESULTS: from mesothelioma was total cohort two maintenance greatest potential exposure asbestos. The insulator group had a standardised ratio (SMR) 3029, larger consisting...

Summary Background Upper gastrointestinal events (UGIE), myocardial infarction (MI) and cerebrovascular accident (CVA) are known morbities among recent NSAID users. Aim To assess all‐cause mortality following UGIE, MI or CVA Methods Veterans >65 prescribed an at any Affairs (VA) facility were identified using prescription fill data their records linked to a merged VA‐Medicare database. Each person‐day was assessed for NSAID, coxib proton pump inhibitor (PPI) exposure. Incidence density...

Protease inhibitors (PIs) have been shown to anti-tumor activity in addition their antiretroviral properties. We sought assess the association between PI use and incidence of squamous cell carcinoma anus (SCCA) HIV-infected individuals. performed a retrospective cohort study among male US veterans diagnosed with HIV who were 1985 2010, using Veterans Affairs Clinical Case Registry (CCR). calculated hazards ratios associated (both as percent time on 12-month intervals use), utilizing...

Objectives: Veterans have an increased risk of laryngeal cancer, yet their oncologic and functional outcomes remain understudied. We sought to determine the longitudinal impact tracheoesophageal puncture voice prosthesis on quality-of-life measures in veterans following total laryngectomy (TL). Methods: performed a cross-sectional analysis TL patients (n = 68) treated at Michael E. DeBakey Affairs Medical Center using Voice Handicap Index (VHI), MD Anderson Dysphagia (MDADI), University...