J Natl Med Assoc
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Tetanus is an infection caused by Clostridium tetani. In the United States, tetanus remains a significant problem primarily among nonimmunized or inadequately immunized individuals. This article reports a fatal case of tetanus that occurred in a 45-year-old parenteral drug abuser who presented to Harlem Hospital Center with nuchal rigidity, trismus, dysphagia, and spasms of the pectoralis musculature. ⋯ Despite aggressive measures that included: endotracheal intubation, administration of human tetanus, hyperimmune globulin, tetanus toxoid, and intravenous penicillin, the patient rapidly deteriorated and manifestations of heightened sympathetic nervous system activity, seizures, and cardiac arrest ensued. The diagnosis of tetanus must be based upon clinical grounds. Clinicians must remain aware of the possibility of tetanus, especially among drug abusers who also are more likely to be evaluated for complications of human immunodeficiency viral infection, which in some cases may mimic tetanus or make the diagnosis more difficult to establish.
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This article describes a study that assesses body fat distribution patterns in Nigerian and African-American males and females and determines the association between body fat distribution patterns and blood pressure in young adults of differing geographical and ethnic backgrounds. The study population was comprised of 275 African Americans (92 males and 183 females) and 282 Nigerians (219 males and 63 females). The mean ages for the African-American males and females were 18.7 and 18.9 years, respectively, compared with 21 and 19.2 years for the Nigerian males and females. ⋯ Despite being leaner, the Nigerians had higher diastolic blood pressures than the African Americans. There were no significant associations observed between blood pressure and waist-to-hip ratio for either the Nigerian or the African-American males or females, and body mass index was associated consistently with blood pressure only among the African Americans. These findings suggest that body mass index, a general indicator of obesity, is a better correlate of blood pressure than the waist-to-hip ratio among African Americans.
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This retrospective case-control study examines risk factors for breast cancer in African-American women, who recently have shown an increase in the incidence of this malignancy, especially in younger women. Our study involves 503 cases from the Howard University Hospital and 539 controls from the same hospital, seen from 1978 to 1987. Using information culled from medical charts, an analysis of various factors for their effect on breast cancer risk was made. ⋯ Spontaneous abortions had a small but significant protective effect in the same subgroup of women. Birth control pill usage conferred a significantly increased risk. It is of note that abortions and oral contraceptive usage, not yet studied in African Americans, have been suggested as possibly contributing to the recent increase in breast cancer in young African-American women.