La Clínica del Pueblo: a model of collaboration between a private media broadcasting corporation and an academic medical center for health education for North Carolina Latinos.

La Clínica del Pueblo, a health education collaboration between the Maya Angelou Center for Health Equity at Wake Forest University School of Medicine and Qué Pasa Media, Inc., disseminates culturally appropriate health information to the North Carolina (NC) Latino community. The program includes a weekly radio show and corresponding newspaper column addressing four areas: childhood health, adult health, safety, and utilization. The radio show format includes a didactic presentation followed by a call-in question and answer period. Over 200 consecutive weeks of programming have been completed, averaging 11 calls per show. A Latino healthcare resource guide and hotline also provide resource information. Participant demographic information indicates that 50% of the target population comes from Mexico, 60% are women, and 70% of the community is younger than 38 years. There was an increase in the use of the media as a source of health information over the course of the project, from an initial 33% of respondents to 58% in the last survey. Listenership to La Clínica del Pueblo displayed a pronounced increase (18% initial survey to 55% in last survey, P < 0.05). We also observed a statistically significant increase in medical knowledge from initial survey to the last survey (P < 0.001). By multiple regression analysis, we identified 4 predictors of medical knowledge: order of surveys (1 < 3, P < 0.001), education level (P < 0.0001), female gender (P < 0.01) and radio listenership (P < 0.05). The first three variables predicted higher scores; however, radio listening recognition of our radio program was more common among individuals who had lower scores. In conclusion, La Clínica del Pueblo is a model for a novel approach that can reach the Latino community to improve medical knowledge and possibly affect health behaviors in a positive manner.

Racial/ethnic disparity and predictors of leisure-time physical activity among U.S. men.

OBJECTIVES: To examine racial/ethnic disparity in and predictors of leisure-time physical activity (LTPA) among men. METHODS: We used the National Health Interview Surveys (NHIS) 1999-2000 data, a multistage probability sampling design producing a U.S. representative sample of 23,459 adult males. Data were analyzed using multinomial logistic regression. RESULTS: The likelihood of engaging in irregular or regular LTPA was associated with younger age, being unmarried, lower household sizes, higher levels of education and income, home ownership, U.S. citizenship, perceived better health status, contact with a health professional within a year, being a non-smoker, living in the West, and residing in a midsize metropolitan statistical area. Hispanics were significantly less likely to engage in regular LTPA than Whites and higher percentages of Hispanics were physically inactive in almost all age and education groups when compared to other races. Disparity between Whites and Blacks was less pronounced. Non-citizen Hispanics were twice as likely to be inactive than citizens and White non-citizens were 40% more likely to be inactive than citizens. Conversely, Black citizens were 20% more likely to be inactive than non-citizens. CONCLUSIONS: Racial/ethnic disparities exist after accounting for socio-demographic characteristics. Not being a citizen exacerbates the disparity between Hispanic and White men. While disparity did exist between Black and White men, this gap was not as large as between Hispanic and White men. Health-seeking behaviors, such as contact with a health professional and non-smoking status are modifiable and influence men of all racial and ethnic backgrounds to engage in LTPA.

Is there a racial difference in presentation of primary hyperparathyroidism?

Nearly 50,000 new cases of primary hyperparathyroidism (PHPT) are diagnosed annually in the United States. Most information about the disease focuses on the white population. We evaluated African American (AA) and white patients at our tertiary care university medical center to determine whether there was a racial difference in presentation of PHPT. A retrospective chart review of patients treated surgically for PHPT between 1997 and 2002 was performed. Demographic data, laboratory values, objective symptoms, surgical procedure, and histologic findings were recorded. The AA participants were matched to whites by age and gender. The effect of race was adjusted for the matching variables by including them in regression models. ANOVA chi2 tests were performed on the race effects. Thirty-six (14.4%) of the 286 patients treated for PHPT at Wake Forest University Baptist Medical Center during this 5-year period were AA. There was no difference in serum calcium or presence of objective symptoms, but PTH levels were significantly higher for blacks (207.5 vs 143.5 pg/mL; P = 0.02). In our study, AA patients had significantly higher parathyroid hormone levels at time of surgical intervention but did not present with a difference in symptoms or more advanced disease. Further research is recommended to characterize ethnic differences in patients with PHPT.

Hemostatic and inflammatory markers in obese youths: effects of exercise and adiposity.

OBJECTIVES: To determine the relation of hemostatic markers to cardiovascular fitness and adiposity and the effect of physical training (PT) on these markers. STUDY DESIGN: Seventy-four obese teenagers were randomly assigned to 8 months of lifestyle education (LSE), LSE plus moderate-intensity PT, or LSE plus high-intensity PT. Measures included fibrinogen, plasminogen activator inhibitor-1 (PAI-1), D-dimer, C-reactive protein (CRP), fitness, percent body fat (%BF), and visceral adiposity (VAT). RESULTS: At baseline, fibrinogen and CRP were significantly correlated with %BF and VAT (0.27

Cardiopulmonary responses to exercise in women with sickle cell anemia.

Multiple factors contribute to exercise intolerance in patients with sickle cell anemia, but little information exists regarding the safety of maximal cardiopulmonary exercise testing (CPET) or the mechanisms of exercise limitation in these patients. The purpose of the present study was to examine these issues. Seventeen adult women with sickle cell anemia underwent symptom-limited maximal CPET using cycle ergometry and ramp protocols; blood gases and lactate concentrations were measured every 2 minutes. All patients completed CPET without complications. No patient demonstrated a mechanical ventilatory limitation to exercise or had evidence of myocardial ischemia. However, we observed three pathophysiologic patterns of response to exercise in these patients. Eleven patients had low peak VO2, low anaerobic threshold (AT), gas exchange abnormalities, and high ventilatory reserve; this pattern is consistent with exercise limitation due to pulmonary vascular disease in this patient subgroup. Three patients had low peak VO2, low AT, no gas exchange abnormalities, and a high heart rate reserve, a pattern consistent with peripheral vascular disease and/or a myopathy. The remaining three patients had low peak VO2, low AT, no gas exchange abnormalities, and a low heart rate reserve; this pattern of exercise limitation is best explained by anemia.