J Natl Med Assoc
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Letter Comparative Study
Low birthweight and black-white differences in hypertension.
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Comparative Study
Risk and outcome of aspiration pneumonia in a city hospital.
Because aspiration pneumonia contributes significantly to morbidity and mortality in hospitalized patients, this study was undertaken to identify risk factors for morbidity and mortality associated with aspiration pneumonia. Patients with a discharge diagnosis of aspiration pneumonia in 1985 and 1990 were studied. ⋯ Fever, cough, and unilateral infiltrates on chest radiograph were associated with survival. Attention to proper positioning of comatose patients, aggressive treatment of gastroesophageal reflux, and strict attention to endotracheal tubes and tracheostomies should decrease the morbidity and mortality associated with aspiration pneumonia.
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This study evaluates the association of cocaine use with short-term change in CD4 counts among human immunodeficiency virus type 1 (HIV-1) seropositive, minority injecting drug users prior to the introduction of zidovudine (AZT). Ninety-eight HIV-1 seropositive subjects were recruited from six inner-city, methadone maintenance clinics. A baseline assessment included a short questionnaire regarding drug behavior and quantitation of CD4 cell counts. ⋯ Cocaine users experienced a significant decline in CD4 cells compared with nonusers (P = .013); no marked difference in CD4 decline was noted between heroin users and nonusers (P = .19). Multivariate analysis showed that a decline in CD4 counts was 2.82 times more likely to occur in cocaine users than in cocaine nonusers (90% two-sided confidence interval of 1.08, 7.37). These findings support the hypothesis of a possible link between cocaine use and short-term CD4 decline in HIV-1 seropositive injecting drug users.
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Lipoprotein phenotypes total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride levels were obtained from blood samples of 189 patients attending the Drew Hamilton Clinic in Central Harlem, New York, between 1987 and 1988. The study population ranged in age from 7 to 88 years; 135 of the patients were females and 54 were males. A difference in distribution of lipoprotein phenotypes was observed compared with the general population of the United States. ⋯ Differences also were observed for blacks versus the general US population for Type IV (24% versus 45%), Type IIB (9% versus 40%), and Type V (0% versus 5%). Types I and III were rare in both groups (0% versus < 1%). The increased frequency of Type IIA among this predominantly black inner-city population may have implications for treatment strategies and prognostic value for predicting the risk of coronary heart disease.