J Natl Med Assoc
-
The prevalence of obesity and being overweight and the distribution of body fat in relation to blood pressure were assessed in a college population of 181 black and white US women and 124 black Nigerian women. The mean ages ranged from 18.6 to 22.4 years. Twenty-nine percent of black US women were overweight and 12.9% were obese; whereas 13.6% of white US women were overweight and 2.3% were obese. ⋯ More upper body fat was found among the black US women and Nigerians than among white US women. There was no significant correlation between body fat distribution and blood pressure among Nigerians. In general, among US blacks and whites, there were positive associations among body mass index, waist-hip girth measurements, and blood pressure, particularly for systolic blood pressure.
-
Parental histories were obtained for a cohort of black medical students in a longitudinal study of hypertension precursors. At follow-up, 25 to 30 years later, initial and current parental histories for hypertension were compared with other precursor characteristics as well as resulting cohort hypertension. The number of participants having no positive parental history for hypertension as parents aged declined from 55% to 24%. ⋯ Having all four risk factors increased the hypertension risk by 15 times. Parental history together with weight gain, blood pressure, and smoking provide a strong predictor of hypertension. Weight and blood pressure control, along with cessation of smoking, should be considered important factors in the clinical management of such patients.
-
Comparative Study
Chronic obstructive pulmonary disease in blacks and whites: mortality and morbidity.
Previous reports cite puzzling racial differences in several indicators of chronic obstructive pulmonary disease (COPD). An extensive review of data from the National Center for Health Statistics and from population-based studies confirmed lower overall COPD but higher asthma mortality in blacks compared with whites, and lower chronic bronchitis and emphysema but similar or higher asthma prevalence in blacks compared with whites. ⋯ Further investigations of racial differences may enhance understanding of COPD etiology and prevention. Physicians and public health organizations should vigorously strive for smoking prevention and cessation in blacks and whites.
-
In a retrospective review of 100 consecutive cases of stab wounds to the chest, 44 patients were successfully treated with tube thoracostomy, 14 patients required thoracotomy, 17 patients with small pneumothoraces were observed, and 25 patients were asymptomatic. The overall mortality was 4%, operative mortality was 7.1%, and the mortality rate for cardiac injuries was 50%. ⋯ Our findings support the opinion that asymptomatic patients (normal chest x-rays) may be discharged after 24 hours of observation and asymptomatic patients with nonprogressive small pneumothoraces (less than 20%) not requiring a chest tube may be discharged after 48 hours of observation. All patients should have close outpatient follow-up.
-
Civilian helicopters and emergency medical services in the United States have been in existence for approximately 15 years. The rapid growth of this type of health care delivery coupled with an increasing number of accidents has prompted professional and lay scrutiny of these programs. ⋯ Significant questions regarding the number of pilots in a helicopter and in a program remain to be answered. This article reviews the role of emergency medical air transport services in providing care to trauma patients, staff training and evaluation, and safety criteria and offers recommendations to minimize risks to patients and crews.