Ethnic Dis
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The purpose of this review is to address the global incidence and management of snakebite envenomation and to describe the clinical characteristics and pathogenesis of envenomation by species of the family Viperidae, genera Bothrops and Crotalus, the most common venomous snakes in Brazil. We focus on the pathogenesis of the acute renal failure induced by these snakes. ⋯ In developed nations, snake bite typically occurs during recreational activities, whereas in developing countries it is an occupational disease more likely to affect young agricultural workers, predominantly men. Scarcity and delay of administration of antivenom, poor health services, and difficulties with transportation from rural areas to health centers are major factors that contribute to the high case-fatality ratio of snakebite envenomation.
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There are well-known Black-White disparities in adverse birth outcomes, health behaviors, and chronic diseases such as asthma, diabetes, and hypertension. These disparities hold across socioeconomic status and have remained stable for the past 50 years despite efforts to reduce them. ⋯ We review evidence that Black neighborhoods have significantly poorer healthcare facilities staffed by less competent physicians, higher environmental exposures, and poorer built environments than do White neighborhoods, and we argue that these neighborhood disparities are 3 pathways through which segregation contributes to health disparities. We summarize the research needed on the role of segregation in health disparities and emphasize the hypothesis that these may be differences between Whites and segregated Blacks alone.
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Review Case Reports
Dysphagia and lung aspiration secondary to anterior cervical osteophytes: a case report and review of the literature.
Two of the most common causes of anterior cervical bony outgrowths are diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis (AS). These osteophytes have been associated with serious complications. The objective of this case report is to highlight how commonly occurring anterior cervical osteophytes may become an uncommon cause for life-threatening dysphagia and potential lung aspiration in elderly patients. ⋯ The patient had onset of symptoms at > 50 years of age, dysphagia, osteophytes in the clavicle and shoulders, anterior cervical osteophytes, calcified posterior longitudinal ligament, and spinal stenosis, all of which are associated with DISH. AS is associated with the patient's history of stooped posture, anterior displacement of the head while walking, and bamboo spine. The final diagnosis, either DISH or AS, causing these life-threatening anterior cervical osteophytes is undetermined because of the inability to evaluate for the respective diagnostic criteria. However, these osseous pathologies must be considered as causes of life-threatening dysphagia and aspiration in an elderly person.
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To review existing data to determine whether racial/ethnic disparities exist for self-monitoring of blood glucose (SMBG) among adults in the United States. ⋯ Despite widespread recommendations for self-monitoring of blood glucose, compliance is reported to be low in all groups in the United States, especially among racial/ ethnic minorities.
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This article offers a brief history of healthcare civil rights, describes a range of healthcare issues that have a civil rights component, and discusses the need for an expanded civil rights framework to guide the provision of health care. Unequal health care based on race and ethnicity has received renewed attention over the past several years, but healthcare discrimination based on socioeconomic status, disability, age, and gender also deserve careful attention.