International journal of epidemiology
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Comparative Study
Black/white comparisons of deaths preventable by medical intervention: United States and the District of Columbia 1980-1986.
Blacks in the US experience increased mortality (1113 versus 745 per 100,000 males; 631 versus 411 per 100,000 females) and decreased life expectancy (63.7 years versus 70.7 years for males; 72.3 years versus 78.1 years for females); compared to Whites. In an effort to determine if the excess mortality among Black Americans might be explained by differences in access or quality of health care services, we performed a race-specific analysis of conditions for which mortality is largely avoidable given timely and appropriate medical care. Using methodology proposed by Rutstein and Charlton, mortality due to 12 causes was evaluated including tuberculosis, cervical cancer, Hodgkin's disease, rheumatic heart disease, hypertensive heart disease, acute respiratory disease, pneumonia and bronchitis, influenza, asthma, appendicitis, hernias and cholecystitis. ⋯ The highest relative rates among Blacks compared to Whites were observed for tuberculosis, hypertensive heart disease and asthma. The overall mortality rate in the District of Columbia for the selected causes was 3.7 times the national rate. Compared to national rates, statistically significant elevated rates in the District were observed for tuberculosis, hypertensive heart disease and pneumonia and bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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The diagnostic usefulness of red cell distribution width (RDW) in association with usual biochemical and haematological parameters in detection of iron deficiency has been studied in a representative sample population of 384 children aged six months to six years in Reunion. Traditional parameters measured included serum ferritin (Fri), total iron binding capacity (TIBC), serum iron (SI), transferrin saturation (TSat), free erythrocyte protoporphyrin (FEP), mean corpuscular haemoglobin concentration (MCHC), mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and haemoglobin concentration (Hb). RDW is an index of the variation in red cell size (anisocytosis). ⋯ In this study, the upper limit value of RDW was defined as 18% using a Technicon model H-6000 counter. Other iron deficiency criteria were also defined and found to be in agreement with the international reference values for children aged six months to six years; MCV less than 70 fl, MCH less than 22 pg, MCHC less than 32%, FEP greater than 35 micrograms/dl whole blood, SI less than 6 mumols/l, TIBC greater than 85 mumols/l, TSat less than 10% and Fri less than 12 micrograms/l. The combination of sensitivity and specificity was best for RDW and worst for MCHC.(ABSTRACT TRUNCATED AT 250 WORDS)