Risk of COVID-19 Reinfection and Vaccine Breakthrough Infection, Madera County, California, 2021.

COVID-19 vaccine efficacy has been evaluated in controlled clinical trials and serves as a benchmark for evaluating the protection acquired from prior COVID-19 infection ("natural immunity"). A cohort of persons with a prior COVID-19 infection was matched to a cohort of COVID-19 vaccinated persons and the risk of reinfection post-COVID-19 infection was compared to the risk of a COVID-19 infection post-vaccination. The hazard ratio (HR) for risk of reinfection from day 90 to 300 after initial COVID-19 infection vs.

Is the stepping-down approach a better option than multiple daily injections in obese patients with poorly controlled Type 2 diabetes on advanced insulin therapy?

Aim: To determine whether de-escalating from advanced insulin therapy (AIT) to the combined use of metformin, an SGLT2 inhibitor, a GLP1 receptor agonist and basal insulin is the better option than multiple daily insulin injections (MDI) in obese patients with poorly controlled T2DM.

Methods: This was a 16-week, prospective, randomized, controlled trial. Twenty-two obese patients with T2DM on AIT were randomized to intervention (step-down) or control (MDI) group.

A case-control study of breast cancer risk and ambient exposure to pesticides.

Unlabelled: While the estrogenic properties of certain pesticides have been established, associations between pesticide exposure and risk of breast cancer have been inconsistently observed. We investigated the relation between pesticide exposure and breast cancer risk using methods capable of objectively assessing exposure to specific pesticides occurring decades before diagnosis.

Methods: A case-control study was conducted to evaluate the risk of postmenopausal breast cancer associated with historic pesticide exposure in California's Central Valley, the most agriculturally productive region in the United States where pesticide drift poses a major source of nonoccupational exposure.

Agricultural Exposures and Breast Cancer Among Latina in the San Joaquin Valley of California.

Objective: The aim of this study was to assess the role of agricultural work, pesticide exposure, and age at first farm labor exposure in breast cancer (BC) risk among Hispanic women in Central California.

Methods: A BC case control study was conducted. Latina BC cases were identified through the California Cancer Registry and controls were recruited.

Estimating the Proportion of Childhood Cancer Cases and Costs Attributable to the Environment in California.

Objectives: To estimate the proportion of cases and costs of the most common cancers among children aged 0 to 14 years (leukemia, lymphoma, and brain or central nervous system tumors) that were attributable to preventable environmental pollution in California in 2013.

Methods: We conducted a literature review to identify preventable environmental hazards associated with childhood cancer. We combined risk estimates with California-specific exposure prevalence estimates to calculate hazard-specific environmental attributable fractions (EAFs).

Complications and Yield of Computed Tomography-Guided Transthoracic Core Needle Biopsy of Lung Nodules at a High-Volume Academic Center in an Endemic Coccidioidomycosis Area.

Purpose: Previous studies with small sample sizes have shown a wide range of complication rates and no study has investigated the yield of computed tomography-guided transthoracic core needle biopsies (CTTCB) for coccidioidomycosis. To better assess the safety, accuracy, and risk factors for complications of CTTCB of pulmonary nodules, we conducted a retrospective study at a high-volume academic center in an endemic coccidioidomycosis area.

Methods: We conducted a retrospective study of 203 patients who underwent CTTCB of pulmonary nodules between December 2010 and May 2013.

Office spirometry correlates with laboratory spirometry in patients with symptomatic asthma and COPD.

Objectives: Spirometry remains underutilized in the evaluation of obstructive lung disease. While office spirometry (OS) has been compared to formal laboratory-based spirometry (LS) in healthy subjects, the correlation has never been formally assessed in patients with symptomatic obstructive lung disease. The aim of this study was to investigate the correlation in this population.

Misdiagnosis Among Frequent Exacerbators of Clinically Diagnosed Asthma and COPD in Absence of Confirmation of Airflow Obstruction.

Purpose: Clinical diagnosis of severe asthma and chronic obstructive lung disease (COPD) remains a challenge and often flawed with lack of objective confirmation of airflow obstruction (AO). Misdiagnosis of asthma and COPD has been reported in stable disease, data are non-existent in frequent exacerbators. We investigated misdiagnosis and its predictors in frequent exacerbators.

Impact of an integrated disease management program in reducing exacerbations in patients with severe asthma and COPD.

Background: Conflicting data exists on the effectiveness of integrated programs in reducing recurrent exacerbations and hospitalizations in patients with Asthma and chronic obstructive lung disease (COPD). We developed a Pulmonologist-led Chronic Lung Disease Program (CLDP) for patients with severe asthma and COPD and analyzed its impact on healthcare utilization and predictors of its effectiveness.

Methods: CLDP elements included clinical evaluation, onsite pulmonary function testing, health education, and self-management action plan along with close scheduled and on-demand follow-up.

Cancer incidence in California farm workers, 1988-2010.

Background: Farmers and farm workers have previously been found to experience decreased risk of some causes of death but elevated risks of certain types of cancer. A previous report on cancer incidence in a farm worker labor union between 1987 and 1997 found increased leukemia, brain, stomach, and uterine cervix cancer rates in this working population.

Methods: A roster of farm workers was created and electronically linked to the database of the California Cancer Registry.

Neutrophil to lymphocyte ratio predicts short- and long-term mortality following revascularization therapy for ST elevation myocardial infarction.

Background: Several inflammation biomarkers have been implicated in the pathogenesis and prognosis of acute coronary syndromes. However, the prognostic role of the neutrophil-lymphocyte white cell interactive response to myocardial injury in predicting short- and long-term mortality after ST elevation myocardial infarction (STEMI) remains poorly defined.

Methods: We evaluated 250 consecutive STEMI patients presenting acutely for revascularization to our tertiary care center over 1 year.

Increased length of stay and costs associated with inpatient management of vascular access failures.

The creation and maintenance of vascular access for hemodialysis patients is responsible for a significant amount of morbidity and hospital expenses which continue to escalate with increasing population of ESRD patients. A retrospective review of patient charts were performed from 2008 to May 2011 at an academic tertiary care center who had a diagnosis of vascular access failure based on ICD 9 coding. Data regarding demographic information, length of stay (LOS), source of insurance, hospital expenses, and discharge status were obtained.

Prevalence of hepatitis B virus (HBV) infection among Hmong immigrants in the San Joaquin Valley.

Chronic hepatitis B infection (HBV) is the major cause of primary liver cancer worldwide and Asians are disproportionately affected. The prevalence of HBV among most Asian American groups has been well documented, except in Hmong immigrants in the United States. The aim of this study was to determine the prevalence of HBV among Hmong immigrants in the San Joaquin Valley of California.

Cancer in migrant and seasonal hired farm workers.

Studies of cancer among farm workers are difficult to conduct and interpret given the unique nature of this occupational group. The transitory nature of the work, high levels of poverty, and lack of legal documentation make epidemiologic studies difficult to accomplish. Nevertheless, this workforce in the United States, which numbers as much as 3 million persons, is a high risk population due to exposures to numerous toxic substances, including excessive sunlight, heat, dangerous machinery, fumes, fertilizers, dust, and pesticides.

Proportionate cancer incidence in the Laotian population of California, 1988-2006.

When the Vietnam War ended in 1975, pro-US Laotians (including Lao, Mien, Khmu) were displaced and became refugees in their own native country. Thousands fled to refugee camps in nearby Thailand and were eventually relocated to several Western countries, including the US. A listing of 1,195 Laotian cancer cases were extracted from the California Cancer Registry for diagnosis years 1988-2006.

Patterns of mortality in California Hmong, 1988-2002.

Background: From mid-1980s to early 1990s, there were several studies evaluating a condition known as "nocturnal sudden death syndrome" among the healthy, young Hmong (immigrants from Laos) individuals who mysteriously died from unknown causes during the night. To date, very little has been reported on the mortality patterns in the Hmong. The purpose of the present study is to examine causes of death (COD) and compare age-adjusted mortality rates (AAMR) in the Hmong with those of non-Hispanic white (NHW) population in California, which may yield useful data for health prevention and planning purposes.

Dietary and lifestyle practices of Hmong in California.

As Hmong adapt to life in Fresno, California, their dietary and lifestyle patterns are examined. Data on tobacco and alcohol use, dietary practices, and socio-demographic variables were collected from a convenience sample, stratified by age and sex. The 248 participants were interviewed.

Cancer incidence in the Middle Eastern population of California, 1988-2004.

International statistics suggest lower cancer incidence in the Middle East and Middle Eastern (ME) immigrants in Europe, Australia, and Canada, but little is known from the United States. This study compares cancer rates in ME population with other race/ethnic groups in California from 1988 through 2004. ME cases in California cancer registry were identified by surname and ME population was estimated from U.

Differences in prognostic factors and survival among white and Asian men with prostate cancer, California, 1995-2004.

Background: There are very limited data concerning survival from prostate cancer among Asian subgroups living in the U.S., a large proportion of whom reside in California.

Cancer survival in California Hispanic farmworkers, 1988-2001.

Context: Although epidemiologic studies have identified elevated cancer risk in farmworkers for some cancer types, little is known about cancer survival in this population.

Purpose: To determine if cancer survival differs between a Hispanic farmworker population and the general Hispanic population in California.

Methods: Hispanic United Farm Workers of America union members and California Hispanics diagnosed from 1988 to 2001 with a first primary cancer were identified from the California Cancer Registry.

Agricultural exposures and gastric cancer risk in Hispanic farm workers in California.

Previous studies have indicated that farm workers may be at increased risk of gastric cancer. Meta-analyses, ecological, case-control, and cohort studies suggest that some aspects of the agricultural environment may be implicated in the elevated risk. Hispanic farm workers in California are exposed to a multitude of potentially toxic substances in the work site, including excessive sunlight, fertilizers, diesel fumes, and pesticides.

Proportionate mortality among current and former members of the United Farm Workers of America, AFL-CIO, in California 1973-2000.

Context: To further investigate mortality among farm workers, a proportionate mortality ratio (PMR) analysis was conducted among the membership of the United Farm Workers of America (UFW), a farm worker labor union, for the years 1973-2000 in the state of California.

Purpose: This report compares proportionate mortality for 118 causes of death in the UFW and the general United States population, adjusting for age, sex, race and calendar year of death. In addition, an exploratory analysis was conducted comparing deaths in the UFW to deaths in the California Hispanic population.