New York City AIDS case mortality rates in the era of potnt antiretroviral therapy

Abstract Colorectal cancer (CRC) incidence rates are rising in younger Americans and mortality rates are increasing among younger white Americans. We used New York State Cancer Registry data to examine New York City CRC incidence and mortality trends among adults ages 20–54 years by race from 1976 to 2015. Annual percent change (APC) was considered statistically significant at P less than .05 using a two-sided test. CRC incidence increased among those ages 20–49 years, yet blacks had the largest APC of 2.2% (1993–2015; 95% confidence interval [CI] = 1.4% to 3.1%) compared with 0.5% in whites (1976–2015; 95% CI = 0.2% to 0.7%). Among those aged 50–54 years, incidence increased among blacks by 0.8% annually (1976–2015; 95% CI = 0.4% to 1.1%), but not among whites. CRC mortality decreased among both age and race groups. These findings emphasize the value of local registry data to understand trends locally, the importance of timely screening, and the need for clinicians to consider CRC among all patients with compatible signs and symptoms.

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Antiretroviral Therapy and Declining AIDS Mortality in New York City

Medical Care ◽

10.1097/01.mlr.0000053230.81725.ef ◽

2003 ◽

Vol 41 (4) ◽

pp. 512-521 ◽

Cited By ~ 15

Author(s):

Peter Messeri ◽

Gunjeong Lee ◽

David M. Abramson ◽

Angela Aidala ◽

Mary Ann Chiasson ◽

...

Keyword(s):

New York ◽

New York City ◽

Antiretroviral Therapy ◽

York City

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Cancer Mortality among Persons with Human Immunodeficiency Virus Infection in New York City, 2001–2015

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.135 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S58-S58

Author(s):

Chitra Ramaswamy ◽

Emily Westheimer ◽

Sarah Braunstein

Keyword(s):

New York ◽

New York City ◽

Cause Of Death ◽

York City ◽

Cancer Mortality ◽

Mortality Rates ◽

Vital Statistics ◽

Cd4 Count ◽

Transmission Risk ◽

The Mean

Abstract Background With the prolonged life-span of persons with HIV (PWH) due to anti-retroviral therapy, their cancer burden has increased. Cancer continues to be a leading cause of death among PWH. Studying cancer mortality can inform and guide the development of cancer screening and prevention strategies for PWH. Methods We analyzed data for all persons > = 13 years who were diagnosed with HIV from 2001 to 2015 and reported to the New York City (NYC) HIV surveillance registry (HSR). Using the HSR and the underlying cause of death obtained from the NYC vital statistics registry and the National Death Index, we examined age-specific and age-standardized mortality rates from cancer and compared time trends of deaths due to HIV-related8 cancer to deaths from non-HIV-related cancers. Results There were 34,190 deaths reported among 154,688 PWH of whom nearly half (n = 16,804; 49.1%) died due to HIV (excluding HIV-related cancers). Among all deaths, HIV was the leading cause, followed by cancer (both HIV and non-HIV-related) (n = 5,271; 15.4%) and cardiovascular disease (n = 3,724, 10.9%). The top three causes of non-HIV-related cancer deaths were lung cancer (n = 1,040; 19.7%), liver cancer (n = 552; 10.5%), and colorectal cancer (n = 315; 5.6%). Although the mortality rate among PWH decreased over time (24.4 to 13.9 per 1,000 person-years from 2001 to 2015), the proportion of deaths attributable to all cancers increased (10.6% in 2001 to 19.9% in 2015, p < .0001). This increase was driven by non-HIV-related cancers (6.1% of all deaths in 2001 to 15.8% in 2015, p < .0001). The mean age increased from 2001 to 2015 among the dead (46 to 56 years) and among the censored (35 to 49 years). After controlling for demographic factors, transmission risk, and last CD4 count, the hazard ratio for cancer deaths was higher among people who inject drugs (HR = 1.5; 95% CI = 1.4–1.7) and those with last CD4 count < 200 (HR = 9.3; 95% CI = 8.3–10.5). Conclusion Although mortality rates are decreasing in PWH, deaths due to non-HIV-related cancers are increasing. The upward trend in the mean age suggests that aging may be contributing to this increase. Routine screening for liver and colon cancers along with smoking cessation may reduce lung, liver and colon cancer deaths. Disclosures All authors: No reported disclosures.

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Population Structure of Klebsiella pneumoniae Causing Bloodstream Infections at a New York City Tertiary Care Hospital: Diversification of Multidrug-Resistant Isolates

Journal of Clinical Microbiology ◽

10.1128/jcm.03455-14 ◽

2015 ◽

Vol 53 (7) ◽

pp. 2060-2067 ◽

Cited By ~ 40

Author(s):

Angela Gomez-Simmonds ◽

Michelle Greenman ◽

Sean B. Sullivan ◽

Joshua P. Tanner ◽

Madeleine G. Sowash ◽

...

Keyword(s):

New York ◽

New York City ◽

Klebsiella Pneumoniae ◽

York City ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Bloodstream Infections ◽

Mortality Rates ◽

Care Hospital ◽

Content Type

Despite the growing importance of carbapenem-resistantKlebsiella pneumoniae(CRKP), the clonal relationships between CRKP and antibiotic-susceptible isolates remain unclear. We compared the genetic diversity and clinical features of CRKP, third-generation and/or fourth-generation cephalosporin-resistant (Ceph-R)K. pneumoniae, and susceptibleK. pneumoniaeisolates causing bloodstream infections at a tertiary care hospital in New York City between January 2012 and July 2013. Drug susceptibilities were determined with the Vitek 2 system. Isolates underwent multilocus sequence typing and PCR sequencing of thewziandblaKPCgenes. Clinical and microbiological data were extracted from patient records and correlated with molecular data. Among 223 patients, we identified 272 isolates. Of these, 194 were susceptible, 30 Ceph-R, and 48 CRKP, belonging to 144 sequence types (STs). Susceptible (127 STs) and Ceph-R (20 STs) isolates were highly diverse. ST258 dominated CRKP strains (12 STs, with 63% ST258). There was minimal overlap in STs between resistance groups. TheblaKPC-3gene (30%) was restricted to ST258/wzi154, whereasblaKPC-2(70%) was observed for severalwziallele types. CRKP infections occurred more frequently among solid organ transplant (31%) and dialysis (17%) patients. Mortality rates were high overall (28%) and highest among CRKP-infected patients (59%). In multivariable analyses, advanced age, comorbidities, and disease severity were significant predictors of 30-day mortality rates, whereas theK. pneumoniaesusceptibility phenotype was not. Among CRKP infections, we observed a borderline significant association of increased mortality rates with ST258 and thewzi154 allele. Although the clonal spread of ST258 continues to contribute substantially to the dissemination of CRKP, non-ST258 strains appear to be evolving. Further investigations into the mechanisms promoting CRKP diversification and the effects of clonal backgrounds on outcomes are warranted.

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Causes of Death among Persons with AIDS in the Era of Highly Active Antiretroviral Therapy: New York City

Annals of Internal Medicine ◽

10.7326/0003-4819-145-6-200609190-00003 ◽

2006 ◽

Vol 145 (6) ◽

pp. 397 ◽

Cited By ~ 309

Author(s):

Judith E. Sackoff ◽

David B. Hanna ◽

Melissa R. Pfeiffer ◽

Lucia V. Torian

Keyword(s):

New York ◽

New York City ◽

Antiretroviral Therapy ◽

York City ◽

Highly Active Antiretroviral Therapy ◽

Causes Of Death ◽

Highly Active

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A Multicenter Study of Initiation of Antiretroviral Therapy and Transmitted Drug Resistance in Antiretroviral-Naive Adolescents and Young Adults With HIV in New York City

Clinical Infectious Diseases ◽

10.1093/cid/ciu003 ◽

2014 ◽

Vol 58 (6) ◽

pp. 865-872 ◽

Cited By ~ 10

Author(s):

Christina Gagliardo ◽

Ava Brozovich ◽

Jeffrey Birnbaum ◽

Anita Radix ◽

Marc Foca ◽

...

Keyword(s):

New York ◽

Drug Resistance ◽

New York City ◽

Young Adults ◽

Antiretroviral Therapy ◽

Multicenter Study ◽

York City ◽

Adolescents And Young Adults ◽

Transmitted Drug Resistance

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Cancer Mortality among Asians and Pacific Islanders in New York City, 2001–2010

Journal of Cancer Epidemiology ◽

10.1155/2013/986408 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Vivian Huang ◽

Wenhui Li ◽

Josephine Tsai ◽

Elizabeth Begier

Keyword(s):

New York ◽

New York City ◽

Ethnic Groups ◽

York City ◽

Cancer Mortality ◽

Nasopharyngeal Cancer ◽

Mortality Rates ◽

Pacific Islanders ◽

Mortality Data ◽

Racial Ethnic

Asians and Pacific Islanders’ (APIs) leading cause of death is cancer. We compared APIs’ age-adjusted cancer mortality rates to other racial/ethnic groups and by API subgroup (i.e., Chinese, Koreans, Asian Indians, and Filipinos) using New York City (NYC) Mortality data and Census Bureau population estimates for 2001–2010. While other racial/ethnic groups’ overall cancer mortality rates declined in NYC during the last decade, APIs remained stable. APIs overall had the lowest mortality rates for more common cancer types (i.e., lung, colorectal, breast, and prostate), but the highest mortality rates for certain less common cancers (i.e., nasopharyngeal, stomach, and liver). Chinese New Yorkers’ lung cancer death rates were very high compared to other APIs and comparable to non-Hispanic whites (47.1/100,000 versus 49.5/100,000, resp.). Chinese men had much higher nasopharyngeal cancer mortality rates (4.5/100,000 versus 0.3/100,000 for non-Hispanic whites). Korean men had the highest liver and stomach cancer mortality rates (25.3/100,000 and 27.7/100,000, resp., versus 7.9/100,000 and 6.0/100,000 for non-Hispanic whites). Analysis of cancer rates by API subgroup provides the detailed information needed to plan cancer prevention efforts. These findings warrant consideration of targeted cancer mortality prevention efforts for affected subgroups, including hepatitis vaccination, screening, and treatment; smoking cessation; and cancer screening.

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COVID-19 infections and outcomes in patients with multiple myeloma in New York City: a cohort study from five academic centers

10.1101/2020.06.09.20126516 ◽

2020 ◽

Cited By ~ 2

Author(s):

Malin Hultcrantz ◽

Joshua Richter ◽

Cara Rosenbaum ◽

Dhwani Patel ◽

Eric Smith ◽

...

Keyword(s):

Risk Factors ◽

New York ◽

Multiple Myeloma ◽

Mechanical Ventilation ◽

New York City ◽

Immune System ◽

Plasma Cell ◽

York City ◽

Mortality Rates ◽

Plasma Cell Disorders

AbstractImportanceNew York City is a global epicenter for the SARS-CoV-2 outbreak with a significant number of individuals infected by the virus. Patients with multiple myeloma have a compromised immune system, due to both the disease and anti-myeloma therapies, and may therefore be particularly susceptible to coronavirus disease 2019 (COVID-19); however, there is limited information to guide clinical management.ObjectiveTo assess risk factors and outcomes of COVID-19 in patients with multiple myeloma.DesignCase-series.SettingFive large academic centers in New York City.ParticipantsPatients with multiple myeloma and related plasma cell disorders who were diagnosed with COVID-19 between March 10th, 2020 and April 30th, 2020.ExposuresClinical features and risk factors were analyzed in relation to severity of COVID-19.Main Outcomes and MeasuresDescriptive statistics as well as logistic regression were used to estimate disease severity reflected in hospital admissions, intensive care unit (ICU) admission, need for mechanical ventilation, or death.ResultsOf 100 multiple myeloma patients (male 58%; median age 68, range 41-91) diagnosed with COVID-19, 74 (74%) were admitted; of these 13 (18%) patients were placed on mechanical ventilation, and 18 patients (24%) expired. None of the studied risk factors were significantly associated (P>0.05) with adverse outcomes (ICU-admission, mechanical ventilation, or death): hypertension (N=56) odds ratio (OR) 2.3 (95% confidence interval [CI] 0.9-5.9); diabetes (N=18) OR 1.1 (95% CI 0.3-3.2); age >65 years (N=63) OR 2.0 (95% CI 0.8-5.3); high dose melphalan with autologous stem cell transplant <12 months (N=7) OR 1.2 (95% CI 0.2-7.4), IgG<650 mg/dL (N=42) OR=1.2 (95% CI 0.4-3.1). In the entire series of 127 patients with plasma cell disorders, hypertension was significantly associated with the combined end-point (OR 3.4, 95% CI 1.5-8.1).Conclusions and RelevanceAlthough multiple myeloma patients have a compromised immune system due to both the disease and therapy; in this largest disease specific cohort to date of patients with multiple myeloma and COVID-19, compared to the general population, we found risk factors for adverse outcome to be shared and mortality rates to be within the higher range of officially reported mortality rates.

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