Charles J. Everett

U.S. Department of Veterans Affairs | VA · Ralph H. Johnson VA Medical Center

We investigated the association between diabetes and p,p′-DDT (dichlorodiphenyltrichloroethane) in blood of Mexican Americans who participated in the 1999–2004 National Health and Nutrition Examination Survey (NHANES). In this sample, p,p′-DDT were missing in 50% of subjects and we used multiple imputation (MI) to address the problem. Compared to i...

Table S1. Hazard Ratio Estimates and 95% CI for Dual Use Table S2. Association Between Site of Episode and Type of First Care With Mortality Among All Patients (Utilization Variables Included) Table S3. Association Between Site of Episode and Type of First Care With Mortality Among Patients That Survived for More Than 30 Days Table S4. Associati...

Background Individuals receiving cross‐system care (dual users) have higher rates of healthcare utilization and worse outcomes for heart failure (HF) and other conditions. Individuals can be dual users or single‐system users at different times, though, and little is known about utilization and mortality within discrete episodes of care. Methods an...

Introduction: Dual healthcare system use is associated with higher rates of healthcare utilization, but the influence of rurality on this phenomenon is unclear. This study aimed to determine the extent to which rurality in the USA modifies the likelihood for acute healthcare use among veterans with heart failure (HF). Methods: Using merged Veter...

BACKGROUND: Heart failure is associated with high mortality, and health system-related factors contribute to this risk. Dual health system use occurs when patients receive care from multiple facilities over time, and such fractured care has been associated with higher healthcare utilization and higher mortality in selected conditions.METHODS: We an...

Concentrations of the pesticide DDT (dichlorodiphenyltrichloroethane) and its metabolite DDE (dichlorodiphenyldichloroethylene), in the blood of Mexican Americans, were evaluated to determine their relationships with diabetes and diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999–2004...

We assessed the association of three chlorinated dibenzo-

Background: Heart failure (HF) frequently causes hospital admission and readmission. Patients receiving care from multiple providers and facilities (dual users) may risk higher health care utilization and worse health outcomes. Methods: To determine rates of emergency department (ED) visits, hospitalizations, and hospital readmissions relative t...

Six organochlorine pesticides and pesticide metabolites in human blood were tested to determine their relationships with diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 (unweighted, n=2992, population estimate=133,088,752). The six chemicals were p,p'-DDT (dichlorodiphenyltric...

Environmental risk factors for diabetic nephropathy include cadmium, iron, lead, arsenic, polychlorinated organic compounds, nitrogen compounds, and contrast agents. We have conducted research on diabetic nephropathy and two classes of polychlorinated organic compounds, namely dioxins, furans and dioxin-like polychlorinated biphenyls (PCBs), and or...

This journey began with the observation that cross-sectional studies of persistent organic pollutants (POPs) and diabetes have shown significant associations, but several longitudinal studies of POPs and diabetes have not [1]. POPs include dioxin, furans, polychlorinated biphenyls (PCBs), and organochlorine pesticides. An additional factor was a de...

Longitudinal Studies of Diabetes in Environmental Epidemiology: Is Incident Diabetes the Right Outcome? While numerous cross-sectional studies have shown associations between environmental pollutants and diabetes, the results of longitudinal studies have been mixed. The question remains, why do some longitudinal studies of incident diabetes and env...

The Lisa Matthews Memorial Bay contains a population of the federally endangered Canby's Dropwort (Oxypolis canbyi). The wetland depression is similar to a Carolina bay, but lacks the classic elliptical shape of Carolina bays. Canby's Dropwort is found in the shallow portion of the bay. The 21-hectare preserve is located on the Coastal Plain in Bam...

Background: Cross-sectional investigation between presence of antibodies and coronary artery calcification (CAC) in past studies has shown no relationship, but progression over time has not been investigated. The objective of this study was to determine the relationship between presence of Chlamydia pneumoniae antibodies and progression of CAC and...

Toxic equivalency factors for dioxins and dioxin-like compounds have been established by the World Health Organization. Toxic equivalency (TEQ) was derived using 6 chlorinated dibenzo-p-dioxins, 9 chlorinated dibenzofurans and 8 polychlorinated biphenyls, in blood, from the 1999-2004 National Health and Nutrition Examination Survey. Relationships o...

Hereditary hemochromatosis (HH) is a common genetic disease in the United States, but little is known about the diagnosis from the patient's perspective. The purpose of this study was to characterize the circumstances surrounding the diagnosis of HH and assess treatments and health information needs. We surveyed US adults aged 18 years and older wh...

Though the benefits of healthy lifestyle choices are well-established among the general population, less is known about how developing and adhering to healthy lifestyle habits benefits obese versus normal weight or overweight individuals. The purpose of this study was to determine the association between healthy lifestyle habits (eating 5 or more f...

The link between pesticide use and type 2 diabetes mellitus has been difficult to establish. Animal studies, cross-sectional studies in humans, and a very limited number of longitudinal studies in humans have been used. Pesticides or pesticide metabolites that have been shown to be associated with diabetes include beta-hexachlorocyclohexane, a meta...

PURPOSE Some studies suggest proprietary (for-profit) hospitals are maximizing financial margins from patient care by limiting therapies or decreasing length of stay for uninsured patients. This study examines the role of insurance related to length of stay once the patient is in the hospital and risk for mortality, particularly in a for-profit env...

Background: To investigate the impact of healthy lifestyle on cardiovascular risk and mortality in people without a history of cardiovascular disease and without elevation of lipid, blood pressure, or inflammatory markers. Design: Cohort study. Methods: Study of a diverse sample of adults in the NHANES III follow-up Mortality Survey, to determ...

Iron overload is associated with significant morbidity and mortality yet is easily treated. The objective of this study was to create a tool that could be easily adapted to clinical practice that indicates the likelihood of a patient having undetected iron overload. We used the National Health and Nutrition Examination Survey (NHANES) 1999-2002 for...

Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). We performed a secondary analysis of data from the 2003-2004 National Health and Nutrit...

It is suggested that targeted screening for hemochromatosis and iron overload may be worthwhile. The aim of this study was to examine uric acid as a potential indicator of the presence of iron overload. We analyzed adults aged 20 and older in the National Health and Nutrition Examination Survey 1999 to 2002. We computed logistic regressions control...

To determine whether pioglitazone 30 mg daily reduces levels of ADMA in adult patients with diabetes, and whether there is improvement in markers of oxidative stress. Prospective randomized cross-over placebo-controlled study of 36 adults age 40-75 years with type 2 diabetes recruited from a single academic health center. Intervention was for 12 we...

Cardiovascular risk is associated with prediabetes states. Ethnic differences in risks related to prediabetes have not been well studied. The purpose of this study was to examine the relationship between prediabetes and the presence of target-organ disease in terms of ethnic differences. Cross-sectional analysis of the Multi-Ethnic Study of Atheros...

In replyBriesacher and colleagues highlight that we identified a greater reduction in mean out-of-pocket expenditures (32%) among Medicare beneficiaries participating in the MEPS1 than previous studies (range, 13%-18%).2,3 They suggest that this may be partly owing to the longitudinal study design used, which limits the generalizability of our find...

Diabetes and hypertension are important contributors to morbidity and mortality worldwide. Both of these conditions are caused by some combination of genetic and environmental factors which may include exposure to persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs). Studies have shown an association between elevated serum...

Electronic health records (EHRs) with clinical decision support hold promise for improving quality of care, but their impact on management of chronic conditions has been mixed. This study examined the impact of EHR-based clinical decision support on adherence to guidelines for reducing gastrointestinal complications in primary care patients on nons...

being unmarried is associated with worse health and increased mortality risk. Telomere length has emerged as a marker for biological ageing but it is unclear how telomere length relates to marital status. to examine the relationship between telomere length and marital status in a sample of middle-aged adults. Design and subjects: cross-sectional an...

To assess diabetes care in a network of primary care practices that include pharmacist support by using a scoring system designed for the National Committee for Quality Assurance (NCQA) Diabetes Recognition Program (DRP) measures. Retrospective medical record review. Subset of the National Interdisciplinary Primary Care Practice-Based Research Netw...

The telomere length is an indicator of biologic aging, and shorter telomeres have been associated with coronary artery calcium (CAC), a validated indicator of coronary atherosclerosis. It is unclear, however, whether healthy lifestyle behaviors affect the relation between telomere length and CAC. In a sample of subjects aged 40 to 64 years with no...

Medicare Part D, introduced in January 2006, was intended to decrease beneficiaries' out-of-pocket expenditures on medications. We examined whether this policy was successful in achieving this goal, including effects on Medicare beneficiaries without previous drug coverage and those who previously received coverage through Medicaid, in a longitudin...

Dietary modifications are common treatment strategies for patients with various chronic diseases, but it is unclear how often these individuals read food labels. The objective of this study was to determine whether patients with chronic disease who are advised to change their eating habits read nutrition labels more than patients who have not been...

Studies have found that vitamin D plays an important role in mediating immune function via a number of pathways, including enhancing the release of antimicrobial peptides in the skin. Given these findings, we hypothesize that low serum vitamin D levels may increase the risk of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). A...

Whether or not blood pressure categories below 140/90 mmHg are associated with incident Type 2 diabetes or cardiovascular disease is subject to debate. Currently, a blood pressure of 120-139/80-89 mmHg is recognized as prehypertension. This article evaluates the association of prehypertension with incident Type 2 diabetes in the San Antonio Heart s...

The associations of 8 pesticides and pesticide metabolites with total diabetes (diagnosed and undiagnosed) and pre-diabetes (glycohemoglobin 5.7-6.4%) were evaluated using the National Health and Nutrition Examination Survey (NHANES), 1999-2004. Six of the pesticides were found to be associated with total diabetes in separate adjusted logistic regr...

Gastro-esophageal reflux disease (GERD) is common in primary care but is often underdiagnosed and untreated. GERD can also present with atypical symptoms like chronic cough and asthma, and physicians may be unaware of this presentation. We aimed to implement and evaluate an intervention to improve diagnosis and treatment for GERD and atypical GERD...

To examine the relationship between a general measure of chronic life stress and atherosclerosis among middle aged adults without clinical cardiovascular disease via pathways through unhealthy lifestyle characteristics. We conducted an analysis of The Multi-Ethnic Study of Atherosclerosis (MESA). The MESA collected in 2000 includes 5,773 participan...

allowing statins to be sold without a prescription has been widely debated in Great Britain, Canada and the USA. To examine the impact of the recent policy in Great Britain allowing patients to purchase over-the-counter (OTC) 10 mg dose of a cholesterol-lowering drug (simvastatin) on meeting the needs of individuals at moderate risk of coronary hea...

The objective of this study was to compare rates of use of medications for diabetes, hypertension, and hypercholesterolemia between 1988-1994 and 2001-2006 and determine whether increased medication use may be partly attributable to nonadherence to healthy lifestyle habits. This study analyzed and compared data from two different time periods in th...

Leukocyte telomere length is representative of biological aging and is associated with clinical coronary artery disease but its association with coronary atherosclerosis is unclear. The objective of this study was to examine the association of telomere length with coronary artery calcification in middle aged adults. Leukocyte telomere length was me...

Fertilizing pine plantations with phosphorus has been a common practice on the Coastal Plain since the 1960s. A decision to fertilize a second or subsequent rotation must take into consideration the availability of residual phosphorus fertilizer. We tested the efficacy of phosphorus applied in a first rotation loblolly pine stand to support the gro...

The association of 9 urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) with serum C-reactive protein (CRP) was investigated using the National Health and Nutrition Examination Survey (NHANES) 2003-2004. The unweighted number of participants included was 999, which represented 139,362,776 persons in the non-institutionalized US populati...

Reducing inappropriate use of antibiotics is key to many antibiotic resistance initiatives. Most initiatives, however, focus almost exclusively on controlling prescribing by health care clinicians and do not focus on patient self-medication. The purpose of this study was to examine antibiotics available to patients without a prescription, a phenome...

To evaluate the association between vitamin D deficiency and insufficiency with diabetic nephropathy across racial/ethnic groups. Cross-sectional analysis of the 2001 to 2006 National Health and Nutrition Examination Survey. A nationally representative sample of 1216 adults (> or =20 years old) with diagnosed diabetes provides population estimates...

To evaluate the cross-sectional relationship of anthropometric measures (body mass index (BMI) and visceral fat and the adipokines leptin and adiponectin) with telomere length in a racially diverse sample. Cross-sectional study of participants recruited from a health science university. Participants include 317 men and women aged 40-64 years withou...

Lifestyle choices are associated with cardiovascular disease and mortality. The purpose of this study was to compare adherence to healthy lifestyle habits in adults between 1988 and 2006. Analysis of adherence to 5 healthy lifestyle trends (>or=5 fruits and vegetables/day, regular exercise >12 times/month, maintaining healthy weight [body mass inde...

To determine whether moderate alcohol intake modifies the association between low vitamin D levels and insulin resistance (IR), we hypothesized that moderate alcohol intake would have a modifying effect on IR in people with low vitamin D levels. This was a cross-sectional analysis of subjects > or = 20 y old without a history of diabetes, coronary...

Objectives To compare diabetes management in adults between England and the United States, particularly focusing on the impact of a universal access health insurance system. Design Analysis of the nationally-representative surveys Health Survey of England, 2003 (unweighted n =14 057) and the National Health and Nutrition Examination Survey, 2001-20...

The aim of this study was to examine the relationship of hepatitis antibodies and liver enzymes with impaired fasting glucose and undiagnosed diabetes in adults. We analyzed the National Health and Nutrition Examination Survey, 1999 to 2004, a nationally representative sample of the noninstitutionalized US population. Among adults (aged >or=20 year...

Fifty-four million people in the United States have impaired fasting glucose (IFG); if it is identified, they may benefit from prevention strategies that can minimize progression to diabetes, morbidity, and mortality. We created a tool to identify those likely to have undetected hyperglycemia. We undertook a cross-sectional analysis of existing dat...

Since preparing ‘‘Association of polychlorinated biphenyls withhypertension in the 1999–2002 National Health and NutritionExamination Survey’’ (Everett et al., 2008, doi:10.1016/j.envres.2008.05.006), polychlorinated biphenyl (PCB) data for the2003–2004 National Health and Nutrition Examination Survey(NHANES) has been made available to the public....

Although many coronary heart disease (CHD) risk factors are known, the role of an individual's changing personal health history is unclear. We implemented this study to evaluate whether accounting for previous Framingham Risk Scores (FRSs) improves the predictive ability of a current FRS for future CHD in middle-aged adults. We analyzed data from t...

The association of 11 polychlorinated biphenyls (PCBs) with hypertension was investigated using the National Health and Nutrition Examination Survey (NHANES), 1999-2002. The unweighted number of participants assessed for hypertension ranged from 2074 to 2556 depending on the chemical(s) being analyzed. In unadjusted logistic regressions all 11 PCBs...

Asthma has been linked to stroke, but it is unknown if hay fever is related to stroke. This study was designed to investigate if there is an association between a reported history of hay fever and stroke during a 4.4-year study period. Analysis was performed of the Atherosclerosis Risk in Communities study, a cohort of middle aged and elderly adult...

We conducted a cross-sectional analysis of individuals 45-79 years old in the National Health and Nutrition Examination Survey III (1988-1994) (NHANES III). Myocardial infarction was determined by electrocardiogram (ECG). Our sample included 4912 participants, which when weighted represented 52,234,055 Americans. We performed adjusted logistic regr...

Eleven soil types, which can be identified and delineated using conventional soil survey procedures, were characterized for loblolly pine (Pinus taeda L.) productivity. Four 4-hectare study sites, each containing four measurement plots, were established for every soil type studied. In a stepwise multiple regression, both soil parent material (i.e....

The prevalence of diabetes is increasing to epidemic levels. A multivariable risk score for the development of diabetes has been shown to be predictive for middle-aged adults; however, it is unclear how well it performs in a younger adult population. The purpose of this study was to evaluate a preexisting multivariable risk score for the developmen...

Prehypertension is associated with increased risk of cardiovascular disease and progression to hypertension. Insulin resistance (IR) is also related to cardiovascular risk. It is unknown whether individuals with prehypertension also have higher IR. The purpose of this study was to examine the association between prehypertension and IR. The National...

To develop a simple, patient self-report-based coronary heart disease (CHD) risk score for adults without previously diagnosed CHD (Personal Heart Early Assessment Risk Tool [HEART] score), the Atherosclerosis Risk In Communities (ARIC) Study, a prospective cohort of subjects aged 45 to 64 years at baseline, was used to develop a measure for 10-yea...

Hispanics in the United States are disproportionately affected by diabetes. We examined the quality of care for Hispanic and non-Hispanic white adults with diabetes to investigate potential disparities in health care. We analyzed the 2004 Behavioral Risk Factor Surveillance System (BRFSS), which included data from 42 states, Puerto Rico, the Virgin...

Associations of race, smoking history and fibrinogen levels with cancer mortality were investigated prospectively using the ARIC study. Our cohort consisted of 14,320 participants aged 45-64 at baseline. In an adjusted Cox regression, black current heavy smokers (> or = 15 cigarettes per day) demonstrated higher risk of respiratory/intrathoracic or...

The aim of this study was to make projections of the future diabetes burden for the adult US population based in part on the prevalence of individuals at high risk of developing diabetes. Models were created from data in the nationally representative National Health and Nutrition Examination Survey (NHANES) II mortality survey (1976-1992), the NHAN...

The association of a polychlorinated dibenzo-p-dioxin, a polychlorinated biphenyl, and p,p'-DDT with diabetes was evaluated using the 1999-2002 National Health and Nutrition Examination Survey. Persons 20 years old and older were included. Relationships with diagnosed diabetes, undiagnosed diabetes (glycohemoglobin (HbA1c) >6.1%), and total diabete...

OBJECTIVES: To examine the relationship between ambulatory antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA between 1996 and 2003. DESIGN: Analysis of data on antibiotic prescribing for episodes of acute bronchitis/cough illness in ambulatory care and hospitalization for respirator...

Clinicians often obtain a panel of lipids but then only use low-density-lipoprotein (LDL) cholesterol to make clinical decisions. We previously described the multiple lipid measure, a strategy that integrates information about seven lipid measures. Our current inquiry uses the multiple lipid measure to create a scoring system and validates that sys...

Objectives To compare diabetes management in adults between England and the United States, particularly focusing on the impact of a universal access health insurance system. Design Analysis of the nationally-representative surveys Health Survey of England, 2003 (unweighted n=14 057) and the National Health and Nutrition Examination Survey, 2001–20...

Nearly one third of diabetes cases in the United States is undiagnosed, with mounting evidence that complications accrue even before clinical diagnosis. We wanted to determine whether persons with undiagnosed diabetes have signs of nephropathy and peripheral neuropathy. We examined the prevalence of positive screening tests for nephropathy and peri...

To compare diabetes management in adults between England and the United States, particularly focusing on the impact of a universal access health insurance system. Analysis of the nationally-representative surveys Health Survey of England, 2003 (unweighted n =14 057) and the National Health and Nutrition Examination Survey, 2001-2002 (unweighted n =...

Increased resting heart rate increases cardiovascular risk in individuals with hypertension. The extent to which such risk extends to people with prehypertension is not known. The purpose of this study was to determine whether elevated resting heart rate contributes to increased coronary heart disease (CHD) risk in people with prehypertension. The...

To examine the relationship between ambulatory antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA between 1996 and 2003. Analysis of data on antibiotic prescribing for episodes of acute bronchitis/cough illness in ambulatory care and hospitalization for respiratory infections for adu...

Objectives To examine the relationship between ambulatory antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA between 1996 and 2003. Design Analysis of data on antibiotic prescribing for episodes of acute bronchitis/cough illness in ambulatory care and hospitalization for respiratory...

Editor's note: Dr. Mainous and his colleagues have addressed an important and emerging global health concern: using generalized ethnic minority comparisons with the majority populations for public health interventions. The investigators looked at aggregate and individual groups within the South Asian population and show that when viewed separately,...

Staphylococcus aureus is a common cause of invasive infections, yet most assessments of prevalence are based on health care-based samples. We computed population-based estimates of nasal carriage of S aureus and risk factors for carriage, as well as population-based estimates of nasal carriage of methicillin-resistant S aureus (MRSA). We used the N...

This study explores the incorporation of sildenafil into treatment of the common conditions of psychosexual and erectile dysfunction (ED). The 2002 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey were analyzed for visits in which sildenafil was prescribed. Patient, visit, and provider characteristics...