Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project.

Mexican Americans are the largest subgroup of Hispanics, the largest minority population in the United States. Stroke is the leading cause of disability and third leading cause of death. The authors compared stroke incidence among Mexican Americans and non-Hispanic Whites in a population-based study. Stroke cases were ascertained in Nueces County, Texas, utilizing concomitant active and passive surveillance. Cases were validated on the basis of source documentation by board-certified neurologists masked to subjects\u27 ethnicity. From January 2000 to December 2002, 2,350 cerebrovascular events occurred. Of the completed strokes, 53% were in Mexican Americans. The crude cumulative incidence was 168/10,000 in Mexican Americans and 136/10,000 in non-Hispanic Whites. Mexican Americans had a higher cumulative incidence for ischemic stroke (ages 45-59 years: risk ratio = 2.04, 95% confidence interval: 1.55, 2.69; ages 60-74 years: risk ratio = 1.58, 95% confidence interval: 1.31, 1.91; ages \u3eor=75 years: risk ratio = 1.12, 95% confidence interval: 0.94, 1.32). Intracerebral hemorrhage was more common in Mexican Americans (age-adjusted risk ratio = 1.63, 95% confidence interval: 1.24, 2.16). The subarachnoid hemorrhage age-adjusted risk ratio was 1.57 (95% confidence interval: 0.86, 2.89). Mexican Americans experience a substantially greater ischemic stroke and intracerebral hemorrhage incidence compared with non-Hispanic Whites. As the Mexican-American population grows and ages, measures to target this population for stroke prevention are critical

Recruiting Injection Drug Users: A Three-Site Comparison of Results and Experiences with Respondent-Driven and Targeted Sampling Procedures

Several recent studies have utilized respondent-driven sampling (RDS) methods to survey hidden populations such as commercial sex-workers, men who have sex with men (MSM) and injection drug users (IDU). Few studies, however, have provided a direct comparison between RDS and other more traditional sampling methods such as venue-based, targeted or time/space sampling. The current study sampled injection drug users in three U.S. cities using RDS and targeted sampling (TS) methods and compared their effectiveness in terms of recruitment efficiency, logistics, and sample demographics. Both methods performed satisfactorily. The targeted method required more staff time per-recruited respondent and had a lower proportion of screened respondents who were eligible than RDS, while RDS respondents were offered higher incentives for participation

The association between CD4+ lymphocyte count and measures of body composition in HIV-infected men

Purpose. This project was designed to describe the association between wasting and CD4 cell counts in HIV-infected men in order to better understand the role of wasting in progression of HIV infection. Methods. Baseline and prevalence data were collected from a cross-sectional survey of 278 HIV-infected men seen at the Houston Veterans Affairs Medical Center Special Medicine Clinic, from June 1, 1991 to January 1, 1994. A follow-up study was conducted among those at risk, to investigate the incidence of wasting and the association between wasting and low CD4 cell counts. Wasting was described by four methods. Z-scores for age-, sex-, and height-adjusted weight; sex-, and age-adjusted mid-arm muscle circumference (MAMC); and fat-free mass; and the ratio of extra-cellular mass (ECM) to body-cell mass (BCM) $\u3e$ 1.20. FFM, ECM, and BCM were estimated from bioelectrical impedance analysis. MAMC was calculated from triceps skinfold and mid-arm circumference. The relationship between wasting and covariates was examined with logistic regression in the cross-sectional study, and with Poisson regression in the follow-up study. The association between death and wasting was examined with Cox\u27s regression. Results. The prevalence of wasting ranged from 5% (weight and ECM:BCM) to almost 14% (MAMC and FFM) among the 278 men examined. The odds of wasting, associated with baseline CD4 cell count $\u3c$200, was significant for each method but weight, and ranged from 4.6 to 12.7. Use of antiviral therapy was significantly protective of MAMC, FFM and ECM:BCM (OR $\approx$ 0.2), whereas the need for antibacterial therapy was a risk (OR 3.1, 95% CI 1.1-8.7). The average incidence of wasting ranged from 4 to 16 per 100 person-years among the approximately 145 men followed for 160 person-years. Low CD4 cell count seemed to increase the risk of wasting, but statistical significance was not reached. The effect of the small sample size on the power to detect a significant association should be considered. Wasting, by MAMC and FFM, was significantly associated with death, after adjusting for baseline serum albumin concentration and CD4 cell count. Conclusions. Wasting by MAMC and FFM were strongly associated with baseline CD4 cell counts in both the prevalence and incidence study and strong predictors of death. Of the two methods, MAMC is convenient, has available reference population data, may be the most appropriate for assessing the nutritional status of HIV-infected men

Injury Mortality in Texas and the Lower Rio Grande Valley, 1980-1998

Aims: To compare age-adjusted injury mortality rates between Lower Rio Grande Valley (LRGV) Hispanics, Texas Hispanics and Texas Whites. Methods: Using data from the Texas Department of Health, we examined deaths from injuries including: motor vehicle accidents, homicide, and suicide from 1980 through 1998. Results: Injury deaths are the fourth leading cause of death in Texas. Mortality rates for all-cause injuries among LRGV Hispanics were 25% lower than rates among Texas Whites. Traffic accident mortality were quite similar among the study groups. From 1980, the average mortality from traffic accidents per 100,000 persons was 21.9 among Whites and 27.2 among LRGV Hispanics; in 1998 the respective rates were 19.3 and 15.2. Mortality from homicide is higher among Texas Hispanics than among Texas Whites and LRGV Hispanics. Although rates have been declining among all groups, Texas Hispanics still have approximately 3 times the homicide mortality as Texas Whites and LRGV Hispanics. In 1980, LRGV Hispanics had 25% more homicides than did Texas Whites and in 1998, they had 80% more homicide deaths. Suicide death rates are highest among Texas Whites and are similar among Texas and LRGV Hispanics. Hispanics experience half the suicide deaths as Texas Whites. However, suicide deaths have decreased nearly 10% among Texas Whites, nearly 20% among Texas Hispanics, and have remained constant among LRGV Hispanics. Over the study period, the difference in mortality has declined, primarily due to decreases in changes favorable to Texas Whites and unfavorable to LRGV Hispanics

Mobiles Smarttracking. Mobile und objektivierbare Untersuchung zur Fahrtüchtigkeit

Teske J, Khosravianarab K, von Jan U, Kanngießer J, Folta-Schoofs K, Albrecht U-V. Mobiles Smarttracking. Mobile und objektivierbare Untersuchung zur Fahrtüchtigkeit. In: Risser R, Dittmann V, Schubert W, eds. Körperliche und geistige Gesundheit und Verkehrssicherheit. Schriftenreihe Fahreignung. Bonn: Kirschbaum; 2014