Michael A. Schork

Socio-ecological stress, suppressed hostility, skin color, and Black-White male blood pressure: Detroit.

&NA; Four areas in Detroit were selected by factor analysis of all census tracts as varying widely in socio‐ecological stressor conditions. High Stress areas were marked by rates of low socio‐economic status, high crime, high density, high residential mobility, and high rates of marital breakup; Low Stress areas showed the converse conditions. All areas were racially segregated. The sample in each area provided about 125 married males, living with spouse, aged 25‐60, with relatives in the city. Blood pressure levels were highest among Black High Stress males and showed no difference among Black Low Stress and White areas. Suppressed Hostility (keeping anger in when attacked and feeling guilt if ones anger is displayed when attacked) was related to high blood pressure levels and percent hypertensive for Black High Stress and White Low Stress males; Black Low Stress men with high pressures were associated with anger in but denying guilt. White High Stress high readings were most associated with guilt after anger. For Blacks, skin color was related positively to blood pressure and High Stress males had darker skin color than Black middle class males. Black High Stress men with dark skin color and suppressed hostility had the highest average blood pressure of all four race‐area groups.

Socioecological stressor areas and black-white blood pressure: Detroit

Abstract 1. 1. Blood pressure does appear to vary with ‘socioecological niches’ or combinations of sex, race and residence, which reflect social class position as well as degree of social stressor conditions. Black High Stress males had higher adjusted levels than Black Low Stress males, while White High Stress females had higher adjusted pressures than White Low Stress females. Black High Stress females had significantly higher observed levels than Black Low Stress females. 2. 2. Black High Stress males had a significantly higher per cent of Borderline and Hypertensive blood pressure than other male race-area groups; White Low Stress females had the lowest of all eight sex-race-stress area groups. 3. 3. For Black males, the younger, overweight High Stress residents had significantly higher Borderline and Hypertensive levels than did a similar Black Low Stress subgroup. Further, for both groups, being raised in Detroit and not migrating from elsewhere was related to higher readings. Tests for age-stress area interaction, however, were not significant.

A study of radiologic imaging techniques and airway grading to predict a difficult endotracheal intubation

STUDY OBJECTIVES To study whether a detailed radiographic examination of neck and upper airway can help identify normal looking patients in whom endotracheal intubation may be difficult; determine whether such parameters as identified by magnetic resonance imaging (MRI) can also be identified in a soft tissue radiograph; and to study the correlation between oropharyngeal appearance, based on Mallampatis classification, and laryngoscopic findings in a large number of patients requiring endotracheal intubation. DESIGN Prospective. SETTING University medical center. PATIENTS 20 adult patients in whom an unanticipated difficult endotracheal intubation was encountered, and a control group of 20 patients in whom endotracheal intubation was easily accomplished. INTERVENTIONS Difficult-to-intubate patients were identified according to prospectively established criteria. Control subjects, in whom the trachea was easily intubated, were matched for age, gender, height, weight, and oropharyngeal appearance. MEASUREMENTS AND MAIN RESULTS In all 40 study patients, a soft tissue radiograph and an MRI scan of the neck were obtained. We measured 21 parameters from both radiographic studies. There were no significant differences between the two groups in 20 of 21 measured parameters on MRI scans and soft tissue radiographs. Only one measurement--the distance between the uppermost visible part of the airway and the posterior pharyngeal wall (measured from MRI scans only)--between the two groups achieved statistical significance. The values recorded from MRI and soft tissue radiographs were not significantly different. Airway grading system first suggested by Mallampati had a fair correlation with laryngoscopy findings associated with a difficult endotracheal intubation. CONCLUSIONS No significant difference between the two groups could be identified on soft tissue radiography or MRI scans.

Transfer Factor in the Treatment of Carcinoma of the Lung

From 1976 to 1982, 63 patients with carcinoma of the lung underwent curative pulmonary resection, mediastinal lymph node dissection, and postoperative mediastinal irradiation when indicated. After operation, the patients were randomized by cell type and stage of disease into two groups. Beginning 1 month postoperatively, Group 1 patients (N = 28) received 1 ml of transfer factor that had been extracted from the blood of normal individuals. Subsequent doses were administered at 3-month intervals. Group 2 patients (N = 35) served as controls. There were no significant differences between the two groups with respect to age, sex, extent of resection, histological cell type, or stage of disease. Twenty of the 28 treated patients were alive and free from disease from 7 to 77 months after treatment, whereas 17 of the 35 control patients were free from disease. The 1-year survival for Group 1 was 84% and for Group 2, 81%. The 2-year survival was 78% for Group 1 and 46% for Group 2 (p = 0.045). The survival rates by stage of disease were as follows: Stage I, 15 out of 17 or 88% in Group 1 and 15 out of 23 or 65% in Group 2 (p = 0.097); Stages II and III, 5 out of 11 or 45% in Group 1 and 3 out of 12 or 25% in Group 2 (p = 0.304). The results of the study suggest that the administration of transfer factor to patients who have undergone pulmonary resection for carcinoma of the lung can have a significant impact on the prolongation of life.