J Natl Med Assoc
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Left ventricular hypertrophy (LVH) is recognized as a cardiovascular risk factor and is a known consequence of sickle cell anemia (SCA). Abnormal left ventricular geometric patterns have been described but the determinants have not been well elucidated. ⋯ Sickle cell anemia predisposes to abnormal LV geometric patterns, especially eccentric LVH. There may be a need to review the electrocardiographic cut off points for defining eccentric LVH in the SCA populace.
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Understanding health concerns and preferences of underserved adolescents has potential to shape health interventions. The objective of this study is to better understand these adolescents' current and preferred health resources, prior to the COVID-19 pandemic. High school students from underrepresented communities in six US cities completed a pre-pipeline program survey in which they reported level of personal concern, as well as current and preferred sources of information about 1) depression/anxiety, 2) nutrition, 3) sexual health, 4) trauma/violence, and 5) alcohol/drugs. 259 participants completed the survey (avg. age 15.7, 79% female, 58.3% Hispanic, and 36.0% Black). ⋯ These results underscore the important role of physicians as educators and suggest a need for improved education on trauma/violence. These results also establish a pre-COVID-19 baseline for adolescent health concerns, current, and preference health resources. This baseline understanding may shift because of pandemic changes.
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Advanced age and comorbidities have been described to increase the risk of mortality associated with COVID-19 infection. However, the degree to which comorbidities influence mortality among younger and older adults with and without comorbidity in COVID-19 infection has not been clearly elucidated. ⋯ A total of 62 patients had adverse outcome while in the hospital (10%). Risk factors independently associated with adverse outcome included advanced age (OR(CI) 9.21 (2.29-37.06), p=.002), male sex (OR(CI) 2.6(1.34-5.16), p=.005), living in most disadvantaged area (OR(CI) 2.42(1.8-5.42), p=.03), history of diabetes (OR(CI) 2.35(1.12-4.95), p=.023), and history of heart failure (OR(CI) 4.00(2.09-7.63), p<.001). Further analysis after creating risk groups based on participants age and the presence of diabetes and / or heart failure was performed. The probability of adverse outcome was highest among older male participants with comorbidities (Pr =0.315 (CI: 0.176-0.454)). The probability of adverse outcome among older participants without diabetes and heart failure (Pr =0.081 (CI: .010 -0.152) was less than the probability for younger patients with diabetes and heart failure (Pr: 203 (CI: 0.103 - 0.303) CONCLUSIONS: While older adults with comorbidities were the most vulnerable for adverse outcome, the risk of adverse outcome among older adults without comorbidities was less than that of younger adults with comorbidities.