Journal of the Association for Academic Minority Physicians : the official publication of the Association for Academic Minority Physicians
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J Assoc Acad Minor Phys · Jan 1995
Cocaine effects on pregnancy and infant outcome: do we really know how bad it is?
While cocaine abuse in pregnancy is associated with a number of negative outcomes for both mothers and infants, it is unclear to what extent cocaine is specifically responsible for these negative outcomes and how its effects are distinct from those associated with substance abuse in general. Use of other drugs commonly associated with cocaine abuse, such as alcohol, marijuana, and tobacco, has also been associated with adverse pregnancy outcomes. ⋯ Epidemiologic data concerning cocaine use in pregnancy describe only associations of drug use and do not prove causality. Future research and longitudinal studies are needed to examine the roles of maternal and environmental factors in predicting differences in cocaine-exposed and nonexposed pregnancies.
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The implications of thrombocytopenia in pregnancy vary with the etiology of the thrombocytopenia. This article focuses on defining what those etiologies are and assessing risk and therapy for each. ⋯ The controversy surrounding the particular therapeutic dilemma of immune thrombocytopenic purpura is explored, with evaluation of the actual danger to the mother, method of delivery, and treatment for the neonate. The serious nature of alloimmune thrombocytopenia is emphasized, and current modes of risk assessment and therapy are discussed.
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J Assoc Acad Minor Phys · Jan 1993
Review Case ReportsSpinal cord sarcoidosis: a case report and review of the literature.
Sarcoidosis is a multisystem syndrome characterized by the development of noncaseating granulomata. These lesions disrupt the architecture and function of the tissue in which they reside. Sarcoidosis in and around the spinal cord is relatively rare. ⋯ Intramedullary lesions respond to medical therapy alone, if at all. Extramedullary lesions may be amenable to surgical resection with postoperative steroid therapy. If treated in time, patients with the latter form generally achieve a nearly full recovery.
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J Assoc Acad Minor Phys · Jan 1993
The high cost of hospital trauma care: an analysis of hospital length of stay, injury severity score, case mix index, and reimbursement-to-cost ratio.
We conducted a study to evaluate reimbursement characteristics for an urban hospital providing a high volume of trauma care. Complete clinical and financial data for 209 trauma patients admitted to the Bronx Municipal Hospital Center during September 1990 were entered into a trauma registry. Patients were categorized into three groups. ⋯ As expected, the length of stay and case mix index were significantly higher for group 1, but they did not differ between group 2 and group 3. Group 1 was a small proportion (7.7%) of trauma patients admitted to the Bronx Municipal Hospital Center level 1 trauma center. Trauma admissions were treated at a net loss, with a projected high annual deficit of $5.3 million.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Assoc Acad Minor Phys · Jan 1991
ReviewAnticholinergic bronchodilators in obstructive airway disease.
The appropriate use of anticholinergic bronchodilating agents in the management of patients with chronic obstructive pulmonary disease (COPD) or asthma is the subject of renewed academic interest. This article examines the physiology of airway function and the pharmacology of anticholinergic agents, and reviews the relevant clinical literature concerning the use of these agents for individuals with chronic obstructive pulmonary disease or asthma. It is suggested that anticholinergic bronchodilators are safe and effective as first-line therapy for COPD and should be considered as adjunctive therapy for asthma.