The Medical clinics of North America
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Med. Clin. North Am. · Sep 2005
ReviewIs there disparity in the care of minority patients with upper aerodigestive tract malignancy?
The data presently available indicate that there is unequal (disparate) care in patients with head and neck cancer. The reasons for this are likely multifactorial and require further study. ⋯ For example, Hispanics are not a homogeneous ethnic group; hence, differences in social perception, cultural mores, and available medical resources can be demonstrated that can directly impact care and outcome. Appropriate epidemiologic studies are needed with more underserved minority patients to analyze these differences further and to address such differences.
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Med. Clin. North Am. · Sep 2005
ReviewPrognostic impact of race and ethnicity in the treatment of colorectal cancer.
Numerous advances in the treatment of patients who have metastatic disease have improved colorectal cancer management, including new chemotherapeutic agents and combinations and targeted agents that modulate the efficacy of chemotherapy. Recent advances in the administration of irinotecan and oxaliplatin, in combination with 5-FU/LV, plus the addition of targeted agents bevacizumab and cetuximab have afforded steady increases in response rates and survival. Ongoing studies are evaluating the optimal sequencing and combinations of the agents described and the efficacy of new combinations in metastatic and adjuvant settings. Because the number of African-American patients in most clinical trials in colorectal cancer has been low, it is imperative that method increase participation so that new research developments reach all segments of the population.
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Med. Clin. North Am. · Sep 2005
ReviewRacial disparities affecting the reproductive health of African-American women.
Until African Americans make a conscious decision to gain control of the social and economic context in which they live, and assume primary responsibility for their health, the reproductive disparities and associated deaths experienced by African-American women will persist. There is truly a need for continued clinical, epidemiologic, and molecular investigations into the problems. Ultimately, however, the permanent elimination of reproductive health disparities will require a social movement, led by members of the target population, informed by the findings of evidenced-based medicine, and fueled by a desire to raise the standard of living of the African-American community. As this occurs, all women will benefit.
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Med. Clin. North Am. · Sep 2005
ReviewHealth disparities in transplantation: focus on the complexity and challenge of renal transplantation in African Americans.
The field of renal transplantation has grown exponentially as a result of a greater understanding of the immune system and the advent of numerous immunosuppressive agents. Although African Americans and whites have benefited from these advances, equivalent long-term success eludes African Americans who are disadvantaged in gaining access to renal transplantation. ⋯ Factors that predispose African Americans for ESRD, impede this ethnic group from timely transplantation, and negatively influence graft survival are examined. Possible solutions to these persistent problems are offered.
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Sarcoidosis is a disease found in most populations worldwide, although it has a proclivity for relatively young African-American women in the United States. Although the pathogenesis is unknown, there likely are social, environmental, and genetic factors that are involved. Sarcoidosis seems to be different between whites and African Americans, with the latter population experiencing more severe and chronic disease. Improving access to care and addressing other disparities in health care may help to bridge the gap in health outcomes observed between patients.