Abstract:
BACKGROUND AND OBJECTIVES:Use of health services in rural communities has not been well studied. We explored how black and white children used health services in a rural Mississippi community. METHODS:Data were prospectively collected for 396 children attending a private practice to determine if race was associated with the use of health services in this community. RESULTS:White children made more sick contacts than black children (P < 0.001). Black children (36%) were more likely to be treated in the emergency room than white children (24%; P = 0.013). There was no black-white difference in the hospitalization rates, although white children were more likely to undergo ear-nose-throat (ENT) surgery for pressure equalizing tube (PET) placement, and/or tonsillectomy and adenoidectomy (T and A; P < 0.001). Even after controlling for various confounders, the frequency of all physician sick contacts was twice as high for white children than for black children (RR = 2.17; 95% C.I. = 1.32-3.58). CONCLUSION:Overall, black children used disproportionately fewer health services than their white counterparts, but used significantly higher emergency room services. Private insurance coverage was the single most significant variable that accounted for the black-white differential use of the emergency room.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Kum-Nji P,Mangrem CL,Wells PJ,Klesges LM,Herrod HGdoi
10.1097/01.smj.0000232966.81950.a4subject
Has Abstractpub_date
2006-09-01 00:00:00pages
957-62issue
9eissn
0038-4348issn
1541-8243journal_volume
99pub_type
杂志文章abstract::This case study supports the plea by a number of psychiatrists for thorough psychiatric and psychologic screening of all persons seeking sexual reassignment surgery. The patient, a female impersonator taking estrogen, was seriously considering such an operation in order to cope with identity problems and an inability ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197504000-00017
更新日期:1975-04-01 00:00:00
abstract::A variant of hereditary hemorrhagic telangiectasia may be gastrointestinal bleeding with no other classical symptoms. This case demonstrates the effectiveness of surgical resection as treatment of duodenal bleeding from telangiectatic lesions. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198703000-00024
更新日期:1987-03-01 00:00:00
abstract::Most patients with intestinal obstruction have had previous surgery. Rarely, the development of adhesions and resulting small bowel obstruction is attributed to previous intra-abdominal trauma. We present the case of a young man, without a history of surgery, who had been a restrained driver in a motor vehicle crash. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:This study compares the primary health care quality of community health centers (CHCs) and health maintenance organizations (HMOs) in South Carolina to elucidate the quality of CHC performance relative to mainstream settings such as the HMO. METHODS:Mail surveys were used to obtain data from 350 randomly sel...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000066811.53167.2E
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:In patients with FIGO (International Federation of Gynecology and Obstetrics) stage I ovarian carcinoma given care with or without subspecialists, we compared completeness of initial staging and disease-free survival. METHODS:Two groups of patients with stage I ovarian carcinoma were compared. Patients were...
journal_title:Southern medical journal
pub_type: 杂志文章,多中心研究
doi:10.1097/00007611-199711000-00008
更新日期:1997-11-01 00:00:00
abstract::High fever occurred in a 30-year-old woman five weeks after transsphenoidal hypophysectomy for a pituitary adenoma. Extensive investigation failed to reveal any evidence of infection, and the clinical findings suggested the fever to be a manifestation of steroid withdrawal. Either suboptimal dosage of corticosteroid r...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198903000-00027
更新日期:1989-03-01 00:00:00
abstract::Using a phylogenic classification of the spine, one can identify precisely the numerical location of any vertebra or disc, including vertebrae with junctional anomalies at transitional zones. Such precision permitted comparisons of myelographic reports of sites of disc disease with the actual levels of extradural defo...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197909000-00017
更新日期:1979-09-01 00:00:00
abstract::Stroke is a treatable disease. Despite the therapeutic nihilism of the past, the advent of thrombolysis has changed the way stroke is approached. Acute ischemic stroke is a challenging and heterogeneous disease. Treatment needs to be based on an understanding of the underlying pathophysiology of ischemia. Intervention...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000063573.56033.A6
更新日期:2003-04-01 00:00:00
abstract::We have described a patient with vaccinia necrosum after smallpox vaccination for persistent herpes labialis. The patient eventually recovered after surgical resection of the lesion and multiple courses of vaccinia immune globulin and methisazone. This report emphasizes the needless risks of vaccinating patients with ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198103000-00044
更新日期:1981-03-01 00:00:00
abstract::We have described a patient with a biopsy-proven mucoepidermoid carcinoma of the orbit. Although it may have represented a metastasis from a malignancy of the upper respiratory tract, clinically it appeared to be a primary neoplasm of the lacrimal gland. This case emphasizes the value of transmission electron microsco...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198905000-00027
更新日期:1989-05-01 00:00:00
abstract::Blastomycosis is an endemic systemic fungal infection that usually involves the lungs and superficial skin. Although head and neck involvement has been reported in the literature, no previous cases of neck mass resulting from direct extension of a pulmonary lesion have been published. We encountered an immunocompetent...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199810000-00009
更新日期:1998-10-01 00:00:00
abstract::The sonographic and clinical findings in four patients with silicone-augmented breasts are presented. The ultrasonographic differences between breasts with silicone injections and breasts with silicone prosthesis are emphasized. Breast sonography may play a role in evaluation of silicone-augmented breasts. Awareness o...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198104000-00021
更新日期:1981-04-01 00:00:00
abstract::This paper reports results of a project designed to examine factors related to compliance with referral for follow-up and treatment of cervical dysplasia. Women studied had cervical dysplasia diagnosed by Pap smear between May 1989 and April 1990. These women had regular follow-up at the gynecology clinic of the Reyno...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199201000-00003
更新日期:1992-01-01 00:00:00
abstract::Extreme bilateral protrusio acetabuli is an unusual complication of hematologic disease. We have described a patient with sickle cell anemia who had this complication probably as a result of osteopenia. Thus sickle cell anemia should be added to the list of potential causes of protrusio acetabuli. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199003000-00018
更新日期:1990-03-01 00:00:00
abstract::The cost of managing chronic ulcers, both venous leg and decubiti (sacral pressure), was reviewed using 36 randomized, controlled studies with a focus on saline, hydrocolloid, and a human skin construct. When one includes the labor intensiveness of dressing changes three to four times per day, the application of hydro...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000082011.70728.8C
更新日期:2004-02-01 00:00:00
abstract::Although it is common in the adult population, sigmoid volvulus is unusual in childhood. We report the cases of four children treated for sigmoid volvulus, and we review an additional 44 cases. The mean age of occurrence was 8 years. Predisposing factors were present in 33%. Abdominal pain (66%), vomiting (31%), and o...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199007000-00015
更新日期:1990-07-01 00:00:00
abstract::We have described a patient with community-acquired, methicillin-resistant Staphylococcus epidermidis endocarditis that occurred on a prolapsing mitral valve. The patient was successfully treated with vancomycin and rifampin for six weeks and had no signs of relapse four months later. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVES:The authors sought to explore patients' views about discussing spiritual issues with primary care physicians, including perceived barriers to and facilitators of discussions. METHODS:The study was a qualitative, semistructured interview of 10 chronically or terminally ill patients who were deliberately sele...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000146486.69217.EE
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVES:Immunochromatographic urine pneumococcal antigen testing (ICT) has become a common diagnostic tool for those presenting with possible invasive pneumococcal disease. The incidence and clinical impact of ICT false-positivity on hospitalized patients has not been assessed outside of specific patient subpopulati...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3182273b82
更新日期:2011-08-01 00:00:00
abstract::Anaerobic bacteria outnumber aerobic bacteria in normal flora in the oropharynx and gastrointestinal tract. They are important and frequent causes of infection, although they often go unrecognized except in the classic and very distincitve clostridial infections and intoxications-gas gangrene, botulism, and tetanus. A...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197609000-00025
更新日期:1976-09-01 00:00:00
abstract:OBJECTIVES:This study describes the clinical problems and psychiatric diagnoses of college students who sought services at a student counseling clinic and were subsequently referred for evaluation by a psychiatrist. Several important psychiatric problems present before leaving for college that could mandate the selecti...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001089
更新日期:2020-05-01 00:00:00
abstract::Compartment syndrome of the leg is usually associated with significant trauma. It has also been associated with prolonged surgery in the hemilithotomy position. Fracture tables that are used for the internal fixation of proximal femur fractures under fluoroscopy place a patient in this position. This report chronicles...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2002-02-01 00:00:00
abstract::Patients treated with ventriculoperitoneal (VP) shunt procedures for hydrocephalus may have abdominal pain related to complications stemming from the shunt tubing itself or to other intra-abdominal disease. In patients with VP shunts, usually children, lack of absorption of cerebrospinal fluid (CSF) may produce a pain...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199208000-00014
更新日期:1992-08-01 00:00:00
abstract::A review of the available clinical and pathologic information suggests that the biologic behavior of prostatic carcinoma can be characterized by one of three different tumor-growth kinetic curves. Failure to identify the biologic potential of the tumor, as indicated by the pattern of its growth curve, can result in in...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1980-10-01 00:00:00
abstract::Two patients with obstruction of the pulmonary veins by bronchogenic carcinoma, an unusual cause, are presented. These and other cases reported have had features suggestive of mitral stenosis. The differential diagnosis is discussed. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197611000-00027
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:Non-insulin-dependent diabetes mellitus (NIDDM) and hyperhomocysteinemia are both associated with increased lipid peroxidation (oxidative stress). This may contribute to the accelerated vascular disease associated with these conditions. It is not known whether the coexistence of elevated homocysteine levels ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199709000-00008
更新日期:1997-09-01 00:00:00
abstract::From our retrospective review of 30 patients having hepatic resection, we have made the following conclusions: (1) Hepatic resection is an uncommon procedure. (2) The majority of liver injuries require only drainage or suture ligation and drainage. (3) Midline incision, early arterial occlusion, and resectional debrid...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198106000-00006
更新日期:1981-06-01 00:00:00
abstract::We have described the radiographic features of a case of solitary giant hepatocellular carcinoma in a noncirrhotic liver. It was angiographically avascular and resembled a massive metastatic tumor. Most hepatocellular carcinomas appear highly vascular on angiography. Hypovascularity may sometimes be encountered in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00027
更新日期:1983-10-01 00:00:00
abstract::An infected echinococcal cyst of the liver was diagnosed in a 48-year-old male immigrant from Spain. After preoperative treatment with mebendazole, microscopic examination of the operative cyst contents showed no viable scoleces or brood capsules of Echinococcus. We recommend the preoperative use of mebendazole in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract::We describe the case of an 11-year-old Bolivian boy with parotitis and aseptic meningitis to demonstrate that parainfluenza virus type 2 can cause disseminated infection in a normal child. Parainfluenza virus type 2 was isolated from nasopharyngeal and CSF specimens from the patient and was confirmed to be parainfluen...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199502000-00014
更新日期:1995-02-01 00:00:00