Pub Date : 2025-12-01Epub Date: 2025-09-08DOI: 10.1016/j.jnma.2025.08.103
Sarah Beeharry , Malachi Scott , Richard Gillum
Background
Non-Hispanic African Americans were reported to have a higher rate of heat-related death than non-Hispanic whites.1 It is not known whether this racial disparity varies among US regions.
Methods
Multiple cause of death data were used to tabulate heat-related death records which listed ICD-10 codes X30 (exposure to excessive natural heat), P81.0 (environmental hyperthermia of newborn), or T67 (effects of heat and light) as the underlying cause of death, or as one of the contributing causes. Using the US 2000 standard population, age adjusted death rates (AADR) were computed for non-Hispanic blacks, non-Hispanic whites, and Hispanics by census division.
Results
In the US from 1999–2020, there were 15,869 deaths which were heat-related. AADR were higher in non-Hispanic blacks than in non-Hispanic whites in each division. In non-Hispanics, the ratio of AADR in blacks to that in whites was about 4.0 in the Middle Atlantic and West North Central Divisions. The lowest ratios were in the Pacific Division (about 1.5) and West South Central Division (about 2.0).
Conclusions
Racial disparities varied greatly by region. Reasons for this marked variation are unclear but worthy of investigation. Geographic variation in disparities in non-fatal heat-related diseases should also be studied.
{"title":"Geographic variation in the racial and ethnic disparity in heat-related death","authors":"Sarah Beeharry , Malachi Scott , Richard Gillum","doi":"10.1016/j.jnma.2025.08.103","DOIUrl":"10.1016/j.jnma.2025.08.103","url":null,"abstract":"<div><h3>Background</h3><div>Non-Hispanic African Americans were reported to have a higher rate of heat-related death than non-Hispanic whites.<span><span><sup>1</sup></span></span> It is not known whether this racial disparity varies among US regions.</div></div><div><h3>Methods</h3><div>Multiple cause of death data were used to tabulate heat-related death records which listed ICD-10 codes X30 (exposure to excessive natural heat), P81.0 (environmental hyperthermia of newborn), or T67 (effects of heat and light) as the underlying cause of death, or as one of the contributing causes. Using the US 2000 standard population, age adjusted death rates (AADR) were computed for non-Hispanic blacks, non-Hispanic whites, and Hispanics by census division.</div></div><div><h3>Results</h3><div>In the US from 1999–2020, there were 15,869 deaths which were heat-related. AADR were higher in non-Hispanic blacks than in non-Hispanic whites in each division. In non-Hispanics, the ratio of AADR in blacks to that in whites was about 4.0 in the Middle Atlantic and West North Central Divisions. The lowest ratios were in the Pacific Division (about 1.5) and West South Central Division (about 2.0).</div></div><div><h3>Conclusions</h3><div>Racial disparities varied greatly by region. Reasons for this marked variation are unclear but worthy of investigation. Geographic variation in disparities in non-fatal heat-related diseases should also be studied.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 6","pages":"Pages 429-432"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-08DOI: 10.1016/j.jnma.2025.08.107
Jessica L. Jones
As an academic Family Medicine physician, I focus my attention on fortifying success for all: teaching, advising, caring for, uplifting anyone I encounter. The systemic divisiveness dominating our culture has been pervasive for centuries. Nevertheless, as physicians, we can be a positive force for our society.
{"title":"Builders or wreckers?","authors":"Jessica L. Jones","doi":"10.1016/j.jnma.2025.08.107","DOIUrl":"10.1016/j.jnma.2025.08.107","url":null,"abstract":"<div><div>As an academic Family Medicine physician, I focus my attention on fortifying success for all: teaching, advising, caring for, uplifting anyone I encounter. The systemic divisiveness dominating our culture has been pervasive for centuries. Nevertheless, as physicians, we can be a positive force for our society.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 6","pages":"Page 437"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-21DOI: 10.1016/j.jnma.2025.06.008
Daniel Laroche , Brian Grodecki , Chester NG
Purpose
In this study, we further evaluated a unique early biomarker that has been demonstrated to be correlated with primary open-angle glaucoma in a pilot study. This novel biomarker correlated an increased ratio of pigmentation in the inferior trabecular meshwork (TM) compared to the superior TM with a greater degree of visual field loss in a small subset of patients. We evaluated this association in a larger group of patients.
Methods
This is a retrospective single-center analysis of Black and Afro-Latino patients that make up the local New York inner-city community of Advanced Eyecare of New York in Queens Village and Harlem, New York City with a diagnosis of primary open-angle glaucoma. We reviewed 335 consecutive glaucoma and glaucoma suspect patients with imaging of the TM via the GS-1 gonioscope. The degree of pigmentation was then quantified using ImageJ software to measure the ratio of pigmentation in the superior to inferior TM. We then created a ratio based on these superior to inferior TM measurements for each patient and compared this ratio to the patient’s mean deviation of the visual field.
Results
Results from 529 eyes in 335 patients demonstrated a positive correlation between the superior-inferior ratio (SIR) of pigmentation and visual field loss. The greater the degree of pigmentation asymmetry between the superior and inferior angle, the greater the extent of visual field deterioration. There was also a positive correlation between the SIR and age.
Conclusion
In a larger cohort of patients with glaucoma or glaucoma suspects, on TM pigment assessment with Image J, there was a positive correlation between SIR and worsening visual field mean deviation. Further research is required to evaluate a greater number of normal patients, glaucoma suspects, and glaucoma patients. Further research is also necessary to produce automated TM images and to develop automated assessment of TM pigment density with artificial intelligence to compare with other clinical factors such as age, IOP, OCT, and retinal nerve fiber layer thickness. Since the TM is where damage initially occurs to cause glaucoma, this can potentially lead to earlier detection before IOP elevation and retinal ganglion cell loss.
{"title":"Objective quantification of trabecular meshwork pigmentation and correlation to primary open-angle glaucoma disease severity","authors":"Daniel Laroche , Brian Grodecki , Chester NG","doi":"10.1016/j.jnma.2025.06.008","DOIUrl":"10.1016/j.jnma.2025.06.008","url":null,"abstract":"<div><h3>Purpose</h3><div>In this study, we further evaluated a unique early biomarker that has been demonstrated to be correlated with primary open-angle glaucoma in a pilot study. This novel biomarker correlated an increased ratio of pigmentation in the inferior trabecular meshwork (TM) compared to the superior TM with a greater degree of visual field loss in a small subset of patients. We evaluated this association in a larger group of patients.</div></div><div><h3>Methods</h3><div>This is a retrospective single-center analysis of Black and Afro-Latino patients that make up the local New York inner-city community of Advanced Eyecare of New York in Queens Village and Harlem, New York City with a diagnosis of primary open-angle glaucoma. We reviewed 335 consecutive glaucoma and glaucoma suspect patients with imaging of the TM via the GS-1 gonioscope. The degree of pigmentation was then quantified using ImageJ software to measure the ratio of pigmentation in the superior to inferior TM. We then created a ratio based on these superior to inferior TM measurements for each patient and compared this ratio to the patient’s mean deviation of the visual field.</div></div><div><h3>Results</h3><div>Results from 529 eyes in 335 patients demonstrated a positive correlation between the superior-inferior ratio (SIR) of pigmentation and visual field loss. The greater the degree of pigmentation asymmetry between the superior and inferior angle, the greater the extent of visual field deterioration. There was also a positive correlation between the SIR and age.</div></div><div><h3>Conclusion</h3><div>In a larger cohort of patients with glaucoma or glaucoma suspects, on TM pigment assessment with Image J, there was a positive correlation between SIR and worsening visual field mean deviation. Further research is required to evaluate a greater number of normal patients, glaucoma suspects, and glaucoma patients. Further research is also necessary to produce automated TM images and to develop automated assessment of TM pigment density with artificial intelligence to compare with other clinical factors such as age, IOP, OCT, and retinal nerve fiber layer thickness. Since the TM is where damage initially occurs to cause glaucoma, this can potentially lead to earlier detection before IOP elevation and retinal ganglion cell loss.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 304-310"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A rare case of Chondrodermatitis nodularis Helicis in an African-American man","authors":"Ogechukwu Opaigbeogu , Jessica Sterner , Ghaidaa Majari , Howard Ragland","doi":"10.1016/j.jnma.2025.07.003","DOIUrl":"10.1016/j.jnma.2025.07.003","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 355-356"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-24DOI: 10.1016/j.jnma.2025.07.011
Felix J. Klimitz , Stav Brown , Sam Boroumand , Thomas Schaschinger , Leonard Knoedler , Adriana C. Panayi , Fortunay Diatta , Martin Kauke-Navarro , Kamal Addagatla
{"title":"Racial disparities in outcomes after lymphedema surgery: A call for equitable care","authors":"Felix J. Klimitz , Stav Brown , Sam Boroumand , Thomas Schaschinger , Leonard Knoedler , Adriana C. Panayi , Fortunay Diatta , Martin Kauke-Navarro , Kamal Addagatla","doi":"10.1016/j.jnma.2025.07.011","DOIUrl":"10.1016/j.jnma.2025.07.011","url":null,"abstract":"","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 296-300"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-10DOI: 10.1016/j.jnma.2025.07.013
Priyanka Goel, Swati Garg, Samta Bali Rathore, Urvashi Sharma
As the incidence of cancer in pregnancy has increased in recent years, multidisciplinary team of specialists involving oncologist and obstetrician has become an integral part of management and decision making. There are various diagnostic and therapeutic challenges in pregnancy associated cancer (PAC) as there are various physiological changes which occur during pregnancy and the signs and symptoms of cancer can be masked resulting in delayed diagnosis and treatment. Antenatal management of cancer during pregnancy should adhere to standard treatment as much as possible to ensure the best possible maternal prognosis but always taking fetal well being into account. Here we present 4 cases with cancer during pregnancy where diagnosis was delayed because of presentations which mimic signs and symptoms common during pregnancy.
{"title":"Pregnancy associated cancer, diagnostic and therapeutic challenges: A case series","authors":"Priyanka Goel, Swati Garg, Samta Bali Rathore, Urvashi Sharma","doi":"10.1016/j.jnma.2025.07.013","DOIUrl":"10.1016/j.jnma.2025.07.013","url":null,"abstract":"<div><div>As the incidence of cancer in pregnancy has increased in recent years, multidisciplinary team of specialists involving oncologist and obstetrician has become an integral part of management and decision making. There are various diagnostic and therapeutic challenges in pregnancy associated cancer (PAC) as there are various physiological changes which occur during pregnancy and the signs and symptoms of cancer can be masked resulting in delayed diagnosis and treatment. Antenatal management of cancer during pregnancy should adhere to standard treatment as much as possible to ensure the best possible maternal prognosis but always taking fetal well being into account. Here we present 4 cases with cancer during pregnancy where diagnosis was delayed because of presentations which mimic signs and symptoms common during pregnancy.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 357-358"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-25DOI: 10.1016/j.jnma.2025.06.006
Devaun Reid , Monica Khadka
This review examines the critical issue of residency attrition among Black physicians in internal medicine, highlighting systemic inequities and unconscious bias within training programs. Analysis of data from 2011 to 2019 shows that Black residents represent only 4.2 % of the internal medicine workforce and face disproportionately high rates of withdrawal and dismissal. The review synthesizes current literature to identify contributing factors such as subjective evaluations, inadequate mentorship, and pervasive racial bias. It proposes targeted interventions including structured one-on-one mentoring, objective and double-evaluation systems, robust feedback mechanisms, and comprehensive bias training for faculty. Implementing these strategies is essential for creating a more inclusive residency environment and advancing healthcare equity.
{"title":"The urgent need to address residency attrition rates among black physicians in internal medicine","authors":"Devaun Reid , Monica Khadka","doi":"10.1016/j.jnma.2025.06.006","DOIUrl":"10.1016/j.jnma.2025.06.006","url":null,"abstract":"<div><div>This review examines the critical issue of residency attrition among Black physicians in internal medicine, highlighting systemic inequities and unconscious bias within training programs. Analysis of data from 2011 to 2019 shows that Black residents represent only 4.2 % of the internal medicine workforce and face disproportionately high rates of withdrawal and dismissal. The review synthesizes current literature to identify contributing factors such as subjective evaluations, inadequate mentorship, and pervasive racial bias. It proposes targeted interventions including structured one-on-one mentoring, objective and double-evaluation systems, robust feedback mechanisms, and comprehensive bias training for faculty. Implementing these strategies is essential for creating a more inclusive residency environment and advancing healthcare equity.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 301-303"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-24DOI: 10.1016/j.jnma.2025.07.008
Ayana Crawl-Bey , Jerome Watts , Jaide Cotton , Uchechi Nwaneri , Samrawit Zinabu , Mekdem Bisrat , Elizabeth Beyene , Ellen Pritchett , Miriam Michael
Background
Alopecia areata is a non-scarring autoimmune condition that causes hair loss and is increasingly linked to mental health disorders. This study examined the incidence of psychiatric conditions among patients newly diagnosed with alopecia areata and explored demographic differences in psychiatric outcomes.
Methods
A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. A total of 97,925 patients with a new diagnosis of alopecia areata were identified using diagnostic codes. After exclusions, 91,302 patients were included in the final analysis. Over a one-year follow-up period, the incidence of depression, anxiety, schizophrenia, obsessive-compulsive disorder, and adjustment disorders was assessed. Survival analysis and risk calculations were performed, and demographic data were analyzed to identify disparities.
Results
Mental health conditions were common in patients with alopecia areata. Anxiety was the most frequent psychiatric diagnosis, affecting 3.1 % of patients, followed by depression at 1.6 %. Adjustment disorders, schizophrenia, and obsessive-compulsive disorder were less common but still present. Patients diagnosed with these conditions experienced repeated episodes, with the highest average episodes per patient seen in those with depression, followed by anxiety. Kaplan-Meier survival analysis showed high probabilities of remaining free from psychiatric conditions during the study period. The average age of patients was 49 years, and 72.06 percent were female. The racial distribution was predominantly White (58.24 %), followed by Black or African American (16.85 %), with other racial groups represented in smaller proportions.
Conclusion
Patients with alopecia areata face a substantial mental health burden, highlighting the need for integrated medical and psychological care.
{"title":"Beyond hair loss: Exploring the psychiatric burden of alopecia areata in a large cohort","authors":"Ayana Crawl-Bey , Jerome Watts , Jaide Cotton , Uchechi Nwaneri , Samrawit Zinabu , Mekdem Bisrat , Elizabeth Beyene , Ellen Pritchett , Miriam Michael","doi":"10.1016/j.jnma.2025.07.008","DOIUrl":"10.1016/j.jnma.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Alopecia areata is a non-scarring autoimmune condition that causes hair loss and is increasingly linked to mental health disorders. This study examined the incidence of psychiatric conditions among patients newly diagnosed with alopecia areata and explored demographic differences in psychiatric outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. A total of 97,925 patients with a new diagnosis of alopecia areata were identified using diagnostic codes. After exclusions, 91,302 patients were included in the final analysis. Over a one-year follow-up period, the incidence of depression, anxiety, schizophrenia, obsessive-compulsive disorder, and adjustment disorders was assessed. Survival analysis and risk calculations were performed, and demographic data were analyzed to identify disparities.</div></div><div><h3>Results</h3><div>Mental health conditions were common in patients with alopecia areata. Anxiety was the most frequent psychiatric diagnosis, affecting 3.1 % of patients, followed by depression at 1.6 %. Adjustment disorders, schizophrenia, and obsessive-compulsive disorder were less common but still present. Patients diagnosed with these conditions experienced repeated episodes, with the highest average episodes per patient seen in those with depression, followed by anxiety. Kaplan-Meier survival analysis showed high probabilities of remaining free from psychiatric conditions during the study period. The average age of patients was 49 years, and 72.06 percent were female. The racial distribution was predominantly White (58.24 %), followed by Black or African American (16.85 %), with other racial groups represented in smaller proportions.</div></div><div><h3>Conclusion</h3><div>Patients with alopecia areata face a substantial mental health burden, highlighting the need for integrated medical and psychological care.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 335-340"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-24DOI: 10.1016/j.jnma.2025.07.004
Derek Nuamah , Jarrell B. Patterson , Joshua E. Lewis , Ertha Sefu Omba , Olivia Anga , Blanche Neige , Raven J. Hollis , Ernst Nicarnord
Introduction
Hypertrophic scarring is a common complication of burn injuries, and its incidence and treatment outcomes vary among racial groups. The motivation for this study was to further understand the disparities in hypertrophic scar formation that exist amongst different racial groups. This study aimed to address the gaps by investigating disparities in hypertrophic scar formation among African American, Asian, and White patients one year after burn injury.
Methods
We conducted a retrospective cohort study using the TriNetX Research Network, a federated database of de-identified electronic health records from over 116 million patients across 112 healthcare organizations (HCOs) as of August 28, 2024. Patients were stratified by race. Propensity score matching adjusted for age, gender, and burn severity. Hypertrophic scarring was assessed at one, six, and twelve months. Relative risk ratio was calculated using White patients as the reference cohort. Statistical significance was deemed p < 0.05.
Results
We identified 633,708 adult burn patients (≥18 years) treated between 2013 and 2023. African American, Asian, and Native Hawaiian patients had significantly higher risks of hypertrophic scarring compared to White patients (p < 0.05). At six months and one-year, similar trends persisted across racial groups. Among the 46,893 patients with hypertrophic scarring, 63.06 % were White, 13.50 % Black, 2.47 % Asian, 0.55 % Native Hawaiian, and 0.54 % American Indian. Interestingly, Native Hawaiians demonstrated a decreased risk in specific subgroup analyses (p < 0.05).
Conclusion
Significant racial disparities exist in hypertrophic scarring incidence following burn injury. African American, Asian, and Native Hawaiian patients are at elevated risk compared to White patients. Further research is needed to develop equitable prevention and treatment strategies for high-risk patient populations.
{"title":"Unequal healing: Racial differences in hypertrophic scarring following burn injuries","authors":"Derek Nuamah , Jarrell B. Patterson , Joshua E. Lewis , Ertha Sefu Omba , Olivia Anga , Blanche Neige , Raven J. Hollis , Ernst Nicarnord","doi":"10.1016/j.jnma.2025.07.004","DOIUrl":"10.1016/j.jnma.2025.07.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypertrophic scarring is a common complication of burn injuries, and its incidence and treatment outcomes vary among racial groups. The motivation for this study was to further understand the disparities in hypertrophic scar formation that exist amongst different racial groups. This study aimed to address the gaps by investigating disparities in hypertrophic scar formation among African American, Asian, and White patients one year after burn injury.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX Research Network, a federated database of de-identified electronic health records from over 116 million patients across 112 healthcare organizations (HCOs) as of August 28, 2024. Patients were stratified by race. Propensity score matching adjusted for age, gender, and burn severity. Hypertrophic scarring was assessed at one, six, and twelve months. Relative risk ratio was calculated using White patients as the reference cohort. Statistical significance was deemed <em>p</em> < 0.05.</div></div><div><h3>Results</h3><div>We identified 633,708 adult burn patients (≥18 years) treated between 2013 and 2023. African American, Asian, and Native Hawaiian patients had significantly higher risks of hypertrophic scarring compared to White patients (<em>p</em> < 0.05). At six months and one-year, similar trends persisted across racial groups. Among the 46,893 patients with hypertrophic scarring, 63.06 % were White, 13.50 % Black, 2.47 % Asian, 0.55 % Native Hawaiian, and 0.54 % American Indian. Interestingly, Native Hawaiians demonstrated a decreased risk in specific subgroup analyses (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>Significant racial disparities exist in hypertrophic scarring incidence following burn injury. African American, Asian, and Native Hawaiian patients are at elevated risk compared to White patients. Further research is needed to develop equitable prevention and treatment strategies for high-risk patient populations.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 315-322"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-07-08DOI: 10.1016/j.jnma.2025.07.002
Uyen Tu Nguyen , Rebekah Smith , Aaron Vang , Marcela Maria Estrada
Purpose
To report a rare case of bilateral juvenile cataracts at the initial ocular sign of Senior-Loken syndrome (SLS) in an 11-year-old girl and to discuss decision-making process for cataract surgery in a pediatric patient undergoing concurrent renal transplantation.
Observation
An 11-year-old girl initially presented with bilateral cataracts and myopic astigmatism but was lost to follow-up for three years. She later developed end stage renal disease secondary to nephronophthisis type 4, requiring dialysis and placement on the transplant waitlist. To optimize quality of life and minimize procedural delays, she underwent successful same-day right eye cataract surgery and kidney transplantation, achieving 20/20 uncorrected vision. Surgery on the left eye was postponed due to post-transplant complications.
Conclusion and Importance
Timely ophthalmologic evaluation in pediatric patients with bilateral cataracts may facilitate early diagnosis of syndromic conditions like SLS. This case demonstrates that simultaneous ophthalmic and renal transplant surgery can be safe and vision-restorative, warranting further study of coordinated surgical approaches in children with end stage renal disease.
{"title":"Bilateral cataracts as an early ocular manifestation of senior-loken syndrome","authors":"Uyen Tu Nguyen , Rebekah Smith , Aaron Vang , Marcela Maria Estrada","doi":"10.1016/j.jnma.2025.07.002","DOIUrl":"10.1016/j.jnma.2025.07.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a rare case of bilateral juvenile cataracts at the initial ocular sign of Senior-Loken syndrome (SLS) in an 11-year-old girl and to discuss decision-making process for cataract surgery in a pediatric patient undergoing concurrent renal transplantation.</div></div><div><h3>Observation</h3><div>An 11-year-old girl initially presented with bilateral cataracts and myopic astigmatism but was lost to follow-up for three years. She later developed end stage renal disease secondary to nephronophthisis type 4, requiring dialysis and placement on the transplant waitlist. To optimize quality of life and minimize procedural delays, she underwent successful same-day right eye cataract surgery and kidney transplantation, achieving 20/20 uncorrected vision. Surgery on the left eye was postponed due to post-transplant complications.</div></div><div><h3>Conclusion and Importance</h3><div>Timely ophthalmologic evaluation in pediatric patients with bilateral cataracts may facilitate early diagnosis of syndromic conditions like SLS. This case demonstrates that simultaneous ophthalmic and renal transplant surgery can be safe and vision-restorative, warranting further study of coordinated surgical approaches in children with end stage renal disease.</div></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"117 5","pages":"Pages 352-354"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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