J Natl Med Assoc
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Comparative Study
The relationship between maternal hematocrit and pregnancy outcome: black-white differences.
Racial differences in hematocrit levels and the relationship between low and high hematocrit, intrauterine growth retardation, and preterm delivery were studied in a population of 17,149 low-income, iron- and folate-supplemented pregnant women. Hematocrit levels drawn during four gestational periods were considered. ⋯ Our major finding was that at 31 to 34 weeks, hematocrits > or = 40% were associated with significantly higher odds ratios for intrauterine growth retardation for both blacks and whites. These findings should prompt more attention to women who have high hematocrits in pregnancy while reducing concern for women of either race with low hematocrits.
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Considerable disparities in cardiovascular and stroke mortality and morbidity rates exist between African Americans and other Americans. Increased prevalence and severity of hypertension, with earlier onset and often inadequate therapy, seem to be the major culprits responsible for the differences. ⋯ The American Heart Association and the National Medical Association have these and many other goals in common. Concerted action by all concerned organizations is essential.
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Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity and mortality in blacks. The prevalence of COPD among blacks was estimated from the spirometry data obtained from the first National Health and Nutrition Examination Survey (NHANES), 1971-1975. Of 873 subjects, 585 (67%) had acceptable spirometry trials. ⋯ The overall prevalence of COPD was 5.4%; 3.7% for males and 6.7% for females. The prevalence was significantly higher with age for both males and females. The multiple logistic regression analyses showed that age and sex were associated with COPD but respiratory symptoms did not attain statistical significance.
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Catheters and chest tubes may be placed under fluoroscopic control to reduce pleural effusions. This procedure has been adopted as a routine procedure at the UCLA School of Medicine in Los Angeles, California to improve patient care. This technique was modified for the placement of large chest tubes, which can be placed by a radiologist without multiple attempts or complications. Our experience with 2234 patients who underwent this procedure between 1977 and 1990 is described.
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An ethnic analysis was made of 8947 cases of primary central nervous system (CNS) tumors seen at the Armed Forces Institute of Pathology (AFIP), Washington, DC, from 1971 to 1985. Results showed a slightly higher frequency of primary CNS tumors in whites than in blacks with a white:black case ratio of 9:1 against the white:black population ratio in the United States of 7.4:1. ⋯ When these results were compared with the results of a previous identical study using similar materials collected at AFIP from 1958 to 1970, the relative paucity of gliomas and higher frequency of meningiomas and pituitary adenomas in American blacks is again confirmed, thus re-emphasizing the importance of genetic factors in the genesis of primary CNS tumors. The remarkable decreasing white:black case ratio of primary CNS tumors as a whole (9:1 compared with 13.7:1) since 1970 probably reflects the socioeconomic improvement of American blacks during the same period.