New York state journal of medicine最新文献

This study contrasts the acquired immunodeficiency syndrome mortality experience of residents of Puerto Rico with that of New York City residents identified as either Puerto Rico-born and non-Puerto Rico-born Hispanics. Portions of the mortality data examined in this investigation update and extend the data previously published describing selected groups in New York City through the end of 1987 but which did not consider residents of Puerto Rico. The nine-year cumulative, age-adjusted acquired immunodeficiency syndrome mortality rate for males was found to be 5 x higher among Puerto Rico-born New York City residents compared with residents of Puerto Rico (702/100,000 v 141/100,000) and 1 1/2 x greater than that of other male Hispanic New York City residents (447/100,000). In New York City, Puerto Rico-born females had higher age-adjusted mortality rates (121/100,000) than female residents of Puerto Rico (25/100,000) and other female Hispanic residents of New York City (70/100,000). Within five of the six age categories considered, acquired immunodeficiency syndrome mortality rates for adult males and females are higher for Puerto-Rico-born, New York City residents. Limitations of acquired immunodeficiency syndrome incidence data, as they pertain to persons of Puerto Rican ancestry, are discussed.

1987 Medicare hospital mortality statistics for 255 New York hospitals (including 57 hospitals in New York City) were compared with 4,617 hospitals located in other states. An analysis of covariance examined how overall Medicare hospital mortality rates differed across states; these rates were adjusted for expected mortality, hospital bed size, and major teaching status. This study tested for the hypothesis that New York State had an average 30-day post-admission Medicare mortality rate significantly different from the mean hospital mortality rate for all states. The results indicated that New York State was -0.43 percentage points below the average risk-adjusted mortality rate of the other states (p < 0.0001). Although it remains speculative to what extent differences in adjusted Medicare hospital mortality are a function of quality of care, these results indicate that New York's historically high level of hospital regulation has not resulted in inferior patient outcomes.

Some anti-convulsant drugs have a calming effect that may potentially be used to reduce cigarette smoking. A cross-sectional study, including all 100 psychiatric in-service patients receiving various anti-convulsant drugs and their age- and sex-matched controls, was done. The intensity of their daily cigarette smoking and their body weights were recorded. Of the patients, 25% were non-smokers. Of the 22 patients on phenytoin, eight were non-smokers as opposed to three in the control group. Two thirds of the phenytoin group patients were either non-smokers, or were nominal smokers. As opposed to this, of the control patients and those on other anti-convulsants, two thirds were either moderate or heavy smokers. The phenytoin group of patients weighed less than the controls (149 v 163 lbs). Valproic acid therapy was associated with a significantly higher body weight and with more smoking. Clonazepam's effect was similar to valproic acid, but carbamazepine did not show any relationship either with smoking or with body weights. Therapy with phenytoin is associated with a lower prevalence and a lower intensity of cigarette smoking, together with lower body weights in psychiatric in-patient population.