Medical Inspection – Health Blog

A. Burden of Adult Vaccine-Preventable Diseases

Vaccine-preventable diseases are responsible for as many as 39,000 adult deaths each year in the U.S. (20,000 from complications of influenza infection, 14,000 from pneumococcal disease, and 5,000 from chronic hepatitis В infection) (CDC, unpublished data). By comparison, childhood immunization programs have drastically reduced the number of vaccine-preventable deaths among children, with fewer than 500 deaths reported each year. Pneumonia and influenza together are the fifth leading cause of death in those aged 65 years and older.

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The National Medical Association (NMA) is the oldest and largest national organization representing African American physicians and health professionals in the United States. Established in 1895, the NMA is the collective voice of more than 22,000 African American physicians and the patients they serve. Since its inception, the NMA has been committed to improving the health status and outcomes of minority and disadvantaged people. While throughout its history the National Medical Association has focused primarily on health issues related to African Americans and medically underserved populations; however, its principles, goals, initiatives and philosophy encompass all sectors of the population.

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ISSUE

Immunizations have been primarily viewed as a preventive health measure for children, however, there has been no concentrated effort to promote immunizations as a preventive health measure to effectively decrease this national health disparity among African American adults.

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Primary renal lymphoma (PRL), describes non-Hodgkin’s lymphoma involving the kidney in the absence of any other organ or nodal disease focus. The majority of patients are older than 40 years and present with acute renal failure. Flank pain, hematuria, weight loss, and abdominal mass are other common manifestations, similar to renal cell carcinoma. PRL presenting with immune thrombocytopenia has also been reported. Lymphoid tissue is normally absent in renal histological architecture and consequently the existence of PRL has been questioned.

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A 79-year-old Caucasian male presented to our unit with symptoms of generalized body aches, weakness and decreased urine output. He is a known patient with chronic renal insufficiency, well-controlled type II diabetes, and myocardial infarction. Physical examination revealed a blood pressure of 154/65 mm Hg and pitting edema of the lower left lumbar region. There was no peripheral lymphadenopathy or pulmonary edema.

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Primary renal lymphoma usually occurs in middle-aged individuals and commonly presents with renal dysfunction. Acute renal failure is associated with a poor prognosis. We present a case of a 79-year-old man who presented with acute-on-chronic renal insufficiency and a unilateral renal mass with biopsy proven low grade В cell non-Hodgkins lymphoma. Non-Hodgkins Lymphoma involving the kidney was first described by Gison in 1948 and again by Davis and Olivelli in 1951Л. Read More…

In this population-based study, a number of recommended measures of quality diabetes care (e.g., monitoring of blood glucose and cholesterol concentrations and screening for foot, and eye disease) were positively associated with patient satisfaction. In this sample of African Americans with diabetes, reported satisfaction with care was generally excellent or good. The perception of not having difficulty getting care, having one physician for diabetes care, and receiving diabetes education were each positively and independently associated with patient satisfaction. As previously reported, levels of diabetes care in this population of African Americans seemed comparable to or better than US national averages.

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