Jared Rutledge - Academia.edu (original) (raw)
Papers by Jared Rutledge
Open Forum Infectious Diseases, 2015
Journal of the International Association of Providers of AIDS Care (JIAPAC), Apr 16, 2014
The incidence of Kaposi's sarcoma (KS) decreased dramatically after the introduction of highly ac... more The incidence of Kaposi's sarcoma (KS) decreased dramatically after the introduction of highly active antiretroviral therapy (HAART). This study determined the ongoing incidence of and mortality from KS in HIV-infected adults from 1998-2012 in Fresno County, California. The role of virologic control and immune reconstitution was assessed. Methods: Incident cases were identified from the state Electronic HIV/AIDS Reporting System (EHARS), the California Cancer Registry, and hospital records of the county HIV treatment center. Results: From 1998-2012, the average incidence of KS was 0.51 cases per 100,000 person-years. Of the 66 cases of KS there were 20 deaths, with 85% of the mortality occurring in the first 12 months. Among patients on HAART achieving HIV RNA <400 copies/uL, but with a <50 cell/uL increase in CD4 count there was no improvement in mortality. Conclusions: The incidence of KS remains stable since 1998 with a 12-month mortality of 30%.
This study evaluated whether emergency department (ED) patient presentations for problems related... more This study evaluated whether emergency department (ED) patient presentations for problems related to mental and substance use disorders could be validly monitored by a syndromic surveillance system that uses chief complaints to identify mental disorders. Methods: The study used syndromic surveillance data on 146,315 ED visits to participating Fresno County, California, hospitals between January 1 and December 31, 2013. Freetext patient chief complaints are automatically classified into syndromes based on the developer's algorithms. Agreement was assessed between the algorithm's syndrome classification of mental health and substance abuse (MHSA) disorders and ICD-9-CM discharge diagnostic codes. Diagnosis and ED utilization patterns among patients with at least one visit with an MHSA syndrome classification were also examined. Results: Approximately 8% of ED visits during the study period received an MHSA syndrome classification. Overall agreement between MHSA syndrome classification and psychiatric-or substance use-related ICD-9 discharge diagnoses was high (k=.92, 95% confidence interval= .91-.92). Sensitivity (100%) and specificity (98.6%) of the MHSA syndrome classification were also very high. MHSA syndrome-classified patients exhibited high levels of health care and morbidity burden compared with other patients. Conclusions: ED chief complaints can be utilized to reliably and validly ascertain the incidence of patient presentations for mental and substance use disorders in contexts in which discharge diagnoses are not routinely available. Wider adoption of MHSA-related syndrome algorithms by syndromic surveillance systems could be valuable for public mental health surveillance, service delivery, and resource planning efforts.
Open Forum Infectious Diseases
MOJ Clinical & Medical Case Reports, 2015
Chikungunya (CHIK-V) is a single-stranded RNA alpha virus of the family Togaviridae, first isolat... more Chikungunya (CHIK-V) is a single-stranded RNA alpha virus of the family Togaviridae, first isolated from mosquitoes and humans during an outbreak in Tanzania in 1952 to 1953. The onset of symptoms of a CHIK-V infection is usually 3-7 days after being bitten. Infection elicits an acute febrile and incapacitating polyarthralgia typically affecting the hands and feet. Other manifestations include headache, myalgia, maculopapular rash, gastrointestinal involvement, and persistent rheumatologic symptoms [1]. With the presence of the vector that spreads CHIK-V (A. aegypti) in Fresno County [2], there is concern that residents who travel abroad to regions endemic for diseases such as Dengue or CHIK-V may import the disease and infect local mosquito species, which could result in local transmission of diseases that have previously not presented in the region. The purpose of the study was to evaluate the attack rate, onset times, and activities of a small group of missionaries who returned from a region endemic for CHIK-V and evaluate the potential for medical and public health action.
UMI, ProQuest ® Dissertations & Theses. The world's most comprehensive collection of dis... more UMI, ProQuest ® Dissertations & Theses. The world's most comprehensive collection of dissertations and theses. Learn more... ProQuest, A hospital and individual level analysis of regional differences of hospital infection rates of methicillin-resistant Staphylococcus aureus. ...
Open Forum Infectious Diseases, 2015
Journal of the International Association of Providers of AIDS Care (JIAPAC), Apr 16, 2014
The incidence of Kaposi's sarcoma (KS) decreased dramatically after the introduction of highly ac... more The incidence of Kaposi's sarcoma (KS) decreased dramatically after the introduction of highly active antiretroviral therapy (HAART). This study determined the ongoing incidence of and mortality from KS in HIV-infected adults from 1998-2012 in Fresno County, California. The role of virologic control and immune reconstitution was assessed. Methods: Incident cases were identified from the state Electronic HIV/AIDS Reporting System (EHARS), the California Cancer Registry, and hospital records of the county HIV treatment center. Results: From 1998-2012, the average incidence of KS was 0.51 cases per 100,000 person-years. Of the 66 cases of KS there were 20 deaths, with 85% of the mortality occurring in the first 12 months. Among patients on HAART achieving HIV RNA <400 copies/uL, but with a <50 cell/uL increase in CD4 count there was no improvement in mortality. Conclusions: The incidence of KS remains stable since 1998 with a 12-month mortality of 30%.
This study evaluated whether emergency department (ED) patient presentations for problems related... more This study evaluated whether emergency department (ED) patient presentations for problems related to mental and substance use disorders could be validly monitored by a syndromic surveillance system that uses chief complaints to identify mental disorders. Methods: The study used syndromic surveillance data on 146,315 ED visits to participating Fresno County, California, hospitals between January 1 and December 31, 2013. Freetext patient chief complaints are automatically classified into syndromes based on the developer's algorithms. Agreement was assessed between the algorithm's syndrome classification of mental health and substance abuse (MHSA) disorders and ICD-9-CM discharge diagnostic codes. Diagnosis and ED utilization patterns among patients with at least one visit with an MHSA syndrome classification were also examined. Results: Approximately 8% of ED visits during the study period received an MHSA syndrome classification. Overall agreement between MHSA syndrome classification and psychiatric-or substance use-related ICD-9 discharge diagnoses was high (k=.92, 95% confidence interval= .91-.92). Sensitivity (100%) and specificity (98.6%) of the MHSA syndrome classification were also very high. MHSA syndrome-classified patients exhibited high levels of health care and morbidity burden compared with other patients. Conclusions: ED chief complaints can be utilized to reliably and validly ascertain the incidence of patient presentations for mental and substance use disorders in contexts in which discharge diagnoses are not routinely available. Wider adoption of MHSA-related syndrome algorithms by syndromic surveillance systems could be valuable for public mental health surveillance, service delivery, and resource planning efforts.
Open Forum Infectious Diseases
MOJ Clinical & Medical Case Reports, 2015
Chikungunya (CHIK-V) is a single-stranded RNA alpha virus of the family Togaviridae, first isolat... more Chikungunya (CHIK-V) is a single-stranded RNA alpha virus of the family Togaviridae, first isolated from mosquitoes and humans during an outbreak in Tanzania in 1952 to 1953. The onset of symptoms of a CHIK-V infection is usually 3-7 days after being bitten. Infection elicits an acute febrile and incapacitating polyarthralgia typically affecting the hands and feet. Other manifestations include headache, myalgia, maculopapular rash, gastrointestinal involvement, and persistent rheumatologic symptoms [1]. With the presence of the vector that spreads CHIK-V (A. aegypti) in Fresno County [2], there is concern that residents who travel abroad to regions endemic for diseases such as Dengue or CHIK-V may import the disease and infect local mosquito species, which could result in local transmission of diseases that have previously not presented in the region. The purpose of the study was to evaluate the attack rate, onset times, and activities of a small group of missionaries who returned from a region endemic for CHIK-V and evaluate the potential for medical and public health action.
UMI, ProQuest ® Dissertations & Theses. The world's most comprehensive collection of dis... more UMI, ProQuest ® Dissertations & Theses. The world's most comprehensive collection of dissertations and theses. Learn more... ProQuest, A hospital and individual level analysis of regional differences of hospital infection rates of methicillin-resistant Staphylococcus aureus. ...