J Natl Med Assoc
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This article examines the relationship between ethnicity, cognitive deficits, functional impairment, and psychiatric symptoms in patients with dementia. The data are from a cross-sectional study of patients evaluated at the Northern California Alzheimer's Disease Center (ADC). Using the ADC database of patient information, the authors compared sociodemographic and clinical variables in 187 African-American patients, 69 Hispanic patients, and 1317 white patients with Alzheimer's disease (AD), ischemic vascular dementia (IVD), and mixed dementia (AD/IVD). ⋯ African-American patients had lower risk for anxiety than whites; 3. Hispanic patients with mixed dementia had lower rates of apathy compared to whites. Future studies are needed to examine how ethnic group differences in dementia are based on the interaction of cultural differences; effects of age, education, and psychosocial variables; and biological differences in the course of dementia.
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Comparative Study
Obesity differences between African-American men and women.
The purpose of this study was to examine the socio-demographic and behavioral differences related to obesity between African-American men and women. Obesity was defined as a body mass index of greater than 27.3 kg/m2 for women and 27.8 kg/m2 for men. Data were collected from 661 African-Americans, 418 women and 243 men, residing in wards 7 and 8 in Washington, DC through telephone interviews. ⋯ For men, older age was a primary association. We concluded that gender, with increasing age, plays a significant role in predicting obesity, as defined by concurrent national standards. African American men 55 years of age or older are the most likely group to be overweight even after predisposing and behavioral risk factors are considered.
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An estimated 7% of all breast cancers and 10% of all ovarian cancers are associated with inherited mutations in BRCA1 and BRCA2 genes. The mutations of a breast cancer-susceptible gene, BRCA1, confers increased risk of breast cancer in young women. Numerous studies have reported specific mutations in the BRCA1 and BRCA2 genes in the white population. ⋯ Each sequence change was confirmed by automatic DNA sequencing. One rare sequence variant, A3537G, has been revealed in high frequency (3/54). Our data suggested that African-American patients with breast cancer carry some unique BRCA1 gene mutations.
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Comparative Study
Enrollment of sudden cardiac death victims into a limited cardiac autopsy study in the emergency department.
The lack of balanced recruitment for racial and ethnic groups in research protocols is an important ethical issue. African Americans have a history of forced participation, unethical research, and unwilling human dissection/demonstration that leads to a lack of participation in clinical research. ⋯ We have screened 14 and enrolled 10 African Americans with sudden death (95% CI 0.41-0.91). By addressing the concerns of the African-American community and involving qualified input in the planning stages of the study we have been able to significantly improve the recruitment rate for this important population subgroup.
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Relatively high serum albumin levels compared to low levels have been associated with reduced cardiovascular mortality and coronary heart disease and stroke incidence. The nature of these associations remains undefined. Therefore, widely accepted criteria of Bradford Hill were used to assess the likelihood that the association is a causal one. ⋯ Favoring a causal association are lack of temporal ambiguity in cohort studies, consistency of findings among studies and biologically plausible mechanisms. Not favoring a causal association are lack of specificity of the association, and inconsistency among age-, sex-groups. Further studies are needed to elucidate mechanisms for the effect of serum albumin on incidence of cardiovascular disease and death.