J Natl Med Assoc
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Biography Historical Article
First black recipient of New York State Medical Society Award: Gerald W. Deas, MD, MPH.
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This study examines the relationship between race and discharge against medical advice from hospitals. Data were taken from the 1990 National Hospital Discharge Survey, which provides national estimates of hospitalizations in short-stay hospitals. Discharges against medical advice by white, African-American, and other race patients were examined. ⋯ In bivariable analyses, African-American patients were 1.78 times more likely then white patients to be discharged against medical advice. This may reflect greater dissatisfaction with inpatient care by African-American patients and may expose them to additional risk for adverse medical outcomes. Optimization of the delivery of inpatient services to patients of all races requires addressing this inequity.
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This article presents a retrospective analysis of the presentation, imaging studies, and associated findings in 20 children with surgically and histologically proven terminal myelocystoceles. All 20 children presented at birth with a black mass; 13 had cloacal extrophy. ⋯ Magnetic resonance imaging was the best imaging modality to diagnose and evaluate children with a myelocystocele. Magnetic resonance imaging demonstrated the classic findings: a terminal cyst of the central canal of the spinal cord that is tethered and herniated with arachnoid and cerebrospinal fluid through an area of spinal dysphria onto the back as a mass.
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Coronary artery disease with subsequent myocardial ischemia is a common cause of morbidity and mortality in the United States, and data are scarce on the prevalence of the disease in blacks. Regional wall motion abnormality correlates either directly or indirectly with myocardial ischemia. This study examines the two-dimensional (2-D) echocardiography of patients > or = 45 years for men and > or = 55 years at Metropolitan Nashville General Hospital, Nashville, Tennessee. ⋯ In relation to race, blacks had a higher prevalence of regional wall motion abnormality compared with whites (29.2% versus 26.2%, respectively), but the difference was not statistically significant. These prevalence rates indicate the importance of looking for this abnormality during echocardiographic evaluation of a patient. The presence of regional wall motion abnormality on 2-D echocardiography in the presence of other cardiovascular risk factors necessitates further investigation and management to minimize later complications of coronary artery disease.