African American Male Research Articles

“I can’t Breathe”: a Delphi study of the proverbial knee on the neck of African American male students

ABSTRACT The plight of African American males continues throughout America and is prevalent in its educational system. Not only are these students negatively impacted by low expectations of their non-African American teachers; policy makers are impeded from devising effective strategies to improve their academic achievement. This qualitative Delphi study explored teacher preconceptions of African American male students to determine the connection between teacher expectations and the academic achievement of these students. Moral exclusion and critical race theory provided the conceptual framework. The findings of the study revealed several perceived preconceptions that included the teacher belief that these students did not care to achieve a quality education. The results provided recommendations to improve the school experience of African American male students by increasing the cultural competence of educators. While the primary recommendation was for teachers to be trained in cultural awareness and diversity; this issue proves to not be an easy fix.

Convenient Frailty: Medical Contestations of Asthma and Hay Fever in African Americans in Late Nineteenth-Century America.

Post-Emancipation medical and social science scholars extensively theorized Black susceptibility to illness, disease, and death. Most studies of late nineteenth-century medical ideas about the relationship between race and disease have highlighted the construction of medical beliefs that associated Black physical weakness with a proclivity to ill health. This study presents an alternate narrative, one where certain diseases - asthma and hay fever - reflected an opposing racialized understanding of disease that instead centered on White frailty. Based on an examination of turn-of-the-century asthma and hay fever medical literature produced by George Miller Beard, the professionalization of the United States Hay Fever Association, and the publication and dismissal of the first recorded case of asthma in an African American man in 1884, this article argues that late nineteenth-century asthma and hay fever physicians, who themselves often suffered from the conditions, defined the typical asthma patient along racial lines to protect the exclusivity of their own professional and social identities. As a result, asthma and hay fever in Black communities, particularly in the North, where asthma and hay fever scholars primarily lived and worked, remained obscured and untreated until the mid-twentieth century.

Demystifying Male Emotional Development: Exploring the Implications of Forced Gender Roles on Black American Males

Statements like “ boys do not cry” and other teaching modalities of emotional blandness can negatively affect the Black American male population with lower emotional development in adulthood. The focus of this study was to understand the extent of self-described societal-forced gender roles in childhood on the emotional development of Black American adult men. A total of 35 participants were interviewed using a qualitative study to further explore these experiences. After analysis, this study determined gender roles and emotional maturity affected later development. Key themes included feeling inept, stigma, lack of understanding, and loneliness. The participants discussed how frustrating it could be to be considered less of a man by society. These frustrations can lead to increased medical issues such as cardiovascular disease and increased behavioral health issues such as substance use, anxiety, depression, and issues within intimate relationships, as women may be expecting more than they can give. Professionals can utilize the findings of the study to further develop processes to teach emotional development in Black American children and assist adult males with their journey toward emotional maturity.

Impact of early corticosteroid withdrawal on simultaneous pancreas-kidney transplant long-term outcomes: Single center experience and comparison to the International Pancreas Transplant Registry.

There remains a paucity of modern data comparing early steroid withdrawal (ESW) versus chronic corticosteroid (CCS) immunosuppression in simultaneous pancreas kidney (SPK) transplant recipients with long-term follow-up. Therefore, the purpose of this study is to assess the effectiveness and tolerability of ESW compared to CCS post-SPK. This was a retrospective single-center matched comparison with the International Pancreas Transplant Registry (IPTR). Patients from University of Illinois Hospital (UIH) represented the ESW group and were compared to those matched CCS patients from the IPTR. Included patients were adult recipients of a primary SPK transplant between 2003 and 2018 within the US receiving rabbit anti-thymocyte globulin induction. Patients were excluded if they had early technical failures, missing IPTR data, graft thrombosis, re-transplant, or positive crossmatch SPK. A total of 156 patients were matched and included in the analysis. Patients were predominantly African American (46.15%) males (64.1%) with Type 1 diabetes etiology (92.31%). Overall pancreas allograft survival (hazard ratio [HR] = .89, 95% confidence interval [CI] .34-2.30, p = .81) and kidney allograft survival (HR = .80, 95%CI .32-2.03, p = .64) were similar between the two groups. Immunologic pancreas allograft loss was statistically similar at 1-year (ESW 1.3% vs. CCS 0%, p = .16), 5-year (ESW 1.3% vs. CCS 7.7%, p = .16), and 10-year (ESW 11.0% vs. CCS 7.7%, p = .99). The 1-year (ESW 2.6% vs. CCS 0%, p>.05), 5-year (ESW 8.3% vs. CCS 7.0%, p>.05), and 10-year (ESW 22.7% vs. CCS 9.9%, p = .2575) immunologic kidney allograft loss were also statistically similar. There was no difference in 10-year overall patient survival (ESW 76.2% vs. CCS 65.6%, p = .63). No differences were found between allograft or patient survival post-SPK when comparing an ESW or CCS protocol. Future assessment is needed to determine differences in metabolic outcomes.

Legionella associated rhabdomyolysis: a case report

BackgroundInfections have been recognized as an uncommon cause of rhabdomyolysis, with evidence indicating a worse prognosis when compared to rhabdomyolysis caused by other etiologies. Diseases caused by Legionella pneumophila can present variably, ranging from mild to severe illness, as is sometimes the case with pneumonia. In particular, the triad of Legionnaire’s disease, rhabdomyolysis, and acute kidney injury is associated with a significant increase in the morbidity and mortality, with most patients requiring initiation of renal replacement therapy such as hemodialysis. While the exact mechanism of both the muscle and kidney injury in this setting remains unknown, several hypotheses exist, with some research suggesting multiple yet distinct processes occurring in both target organs.Case presentationIn this case report, we describe a 53-year-old African American man who presented with Legionella pneumophila pneumonia complicated by rhabdomyolysis and acute kidney injury. He was treated with aggressive fluid resuscitation and a 2-week course of azithromycin. His clinical status improved without necessitating renal replacement therapy or mechanical ventilation. We postulate that early recognition and treatment were key to his recovery. He was discharged 10 days later without recurrence of rhabdomyolysis at the time of this report.ConclusionWhile there are several well-established and more common causes of rhabdomyolysis, clinicians should recognize Legionella sp. as an etiology, given its association with significant morbidity and mortality.

1475-P: Novel Mutations in the Wolframin Gene with Diabetes—A Case Series of a Potential Addition to the Monogenic Diabetes Profile

Monogenic DM (MGDM) is a heterogeneous group of disorders caused by single gene mutations resulting in variable clinical phenotypes of diabetes mellitus (DM). While maturity onset diabetes of the young (MODY) remains the most known group, it is now recognized that there are other single gene defects associated with DM. Current MODY classification details 14 distinct genetic types which are mostly autosomal dominant (AD). We present a case series of 4 African-American (AA) men with novel mutations of the Wolframin (WS1) gene and type 2 DM (T2DM) phenotype. Patient 1 is a 54-yr-old AA man with presumed T2DM. Given his lack of family DM history, short DM duration, late onset and rapid renal functional decline, the possibility of atypical DM was considered. Genetic testing showed a heterozygous mutation of the WFS1 (wolframin gene); c.169 G>A, p.Ala57Thr. He had no other features of Wolfram’s syndrome; DIDMOAD (diabetes insipidus, DM, optic atrophy + deafness). Pts 2-4 are all family members. Pt 2 is a 65-yr-old AA man with new onset DKA and presumed T2DM. Given his initial DKA presentation, non-obese phenotype and absent family DM history, full phenotyping was done and genetic testing revealed a heterozygous mutation of the WFS1 gene; c.2385 G>C, p.Glu795Asp. He had no other features of DIDMOAD. Neither of his parents had DM and nor does his wife. He has 3 children (two sons and a daughter). Both sons (Pts 3-4), aged 41 and 36 yrs, have DM and both have the same WFS1 mutation. Both sons were diagnosed with DM before their father. The familial distribution suggests possible AD transmission. WFS1 mutations have a broad spectrum of phenotypes and inheritance patterns. Our case series with unique WFS1 mutations suggests a possible MGDM syndrome in subjects with heterozygous WFS1 mutations without DIDMOAD. Further functional analyses of WFS1 mutations associated with DM without DIDMOAD are needed to better understand their DM pathophysiology and inform best management strategies. Disclosure Z.Yin: None. A.A.Noor: None. K.G.Romo: None. S.Bhamre: None. M.Gabriel: None. T.Pulisetty: None. S.Shu: None. G.I.Uwaifo: None.

A Cross-Sectional Study of the Trends in Cardiovascular Mortality Among African Americans With Hypertension.

Background and Objective In the United States, hypertension remains a significant cause of cardiovascular disease mortality and morbidity, affecting various racial and ethnic groups. High blood pressure is a common health concern, given its high frequency among all populations and racial groups in the United States; nevertheless, the condition remains untreated in most individuals. It affects a significant number of individuals in the African American community and contributes to a notable proportion of deaths. Arguably more prevalent, severe, and tends to occur earlier in African Americans compared to some other races. This lack of blood pressure control may contribute to the increasing mortality rates associated with hypertension-related cardiovascular diseases in the United States, while notable race and sex disparities persist. This study aims to compare the number of deaths caused by each cardiovascular disease (hypertension) in African Americans to those of people of other races. Methodology To understand the impact of hypertension on mortality rates among different racial groups, this study utilized the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER)dataset, which includes death certificates filed in the United States. The research focused on individuals aged 25 years or older with a mention of hypertension and cardiovascular disease as the underlying cause of death between 1999 and 2019. The study analyzed hypertension-associated deaths by different cardiovascular disease subtypes, such as ischemic heart disease, heart failure (HF), and cerebrovascular diseases that include acute ischemic attacks, which are the most frequent in the United States, with specific assessments for African Americans, White, and other races' decedents. Results The study findings indicated that African American males had higher mortality rates from cardiovascular diseases compared to African American females. The prevalence of hypertension was also higher among African Americans (87.47%) compared to Whites (30.33%), Asian/Pacific Islanders (40.26%), and American Indians/Alaska Natives (61.18%). Additionally, the study identified regional variations in mortality rates, with states like Arizona, California, Texas, Florida, and Washington having higher rates, while Vermont, North Dakota, and Wyoming had lower rates. The northwest region had lower mortality compared to the western and southwestern regions. Conclusions Within the studied period, there was an increase in the prevalence of mortality due to hypertension amongst African Americans when compared to other races. These findings underscore the pressing need to address the increasing prevalence of hypertension and mortality rates among African American. More efforts should focus on prevention of CVD and hypertension and the associated risk factors based on the World Health Organization (WHO) recommendations, which include the promotion of healthy lifestyle behaviors, improvement of access to quality healthcare,and implementation ofculturally sensitive interventions tailored for African American communities.

Queer Affect at Work

Early on in her often moving new book, Queer Career, Margot Canaday quotes from an oral history interview she conducted in New York in 2012, at the very beginning of her research. The participant, an African American gay man, recalled his entry into the working world: “I was a typist, and I wanted to type.” The sentence provides early evidence for one of the major findings of the book, that before gay liberation, many queer and trans people chose lower-paying jobs in office and service work because it allowed for greater flexibility to pursue a sexual and social life outside of their job, and because there was less to lose if you were arrested. But Canaday also slows down to parse not just the speaker's words but also his intonation. As Canaday recalls, “[H]e didn't just state this; he joyfully exclaimed it: ‘I was a typist,’ his voice rose, ‘and I wanted to type!’” (19).

Cutting-edge medicine: A case of hypertension managed at the barbershop

We present a case of 43-year-old African American man, MS, who was diagnosed with hypertension at his barbershop after getting his blood pressure taken by a pharmacist team during his haircut. He was started on blood pressure medications and made several lifestyle modifications. He continued to get his blood pressure checked weekly during haircuts for the next six months and was able to lower his blood pressure to heathy levels. MS was then able to manage his blood pressure solely through lifestyle changes. We further discuss the significance of “barbershop medicine” and its role in combating the racial disparities in usual sources of care, as well as other non-traditional sources of health care particularly for the hypertension management.

Early identification of cognitive impairment among vulnerable older adults living at home

AbstractBackgroundAfrican Americans are twice as likely as Caucasians to develop Alzheimer’s Disease and Related Dementias (AD/ADRD) and less likely to seek a diagnosis before experiencing a crisis. This study evaluated the impact of adding Mini‐Cog© screenings to Area Agency on Aging (AAA) assessments on early detection of cognitive impairment among low‐income older adults.MethodMini‐Cog™ assessments were offered to new and existing clients of a AAA Neighborhood Advisor. Clients with scores indicating impairment were referred to an academic geriatric practice for comprehensive evaluation. Inclusion criteria were age 65 or older, English speaking, living at home in the Advisor’s service area, and not previously diagnosed as AD/ADRD. Data collected over 9 months included Mini‐Cog™ scores, age, race, ethnicity, and geriatric referrals. Quantitative analysis included bivariate descriptive statistics (significance alpha of .10) and simple linear regression (significance alpha of .05).ResultsOf 69 study participants, 84% were female, 54% African American, and 93% non‐Hispanic. Mean age was 74.7 years and mean Mini‐Cog™ score was 3.61 (range: 0‐5). Independent t‐tests show that African American participants had lower Mini‐Cog™ scores than Caucasians (3.35±.23 vs 3.91±.22, p = .092). Caucasian males were younger with higher cognition scores than Caucasian women and African American males were younger with lower scores than African American females. Participants qualifying for referral (18 or 26%) were significantly older than those who did not (74.4 vs 70.0, p<.05). Of 11 participants offered referrals, all Caucasians (3) declined and 5 of 8 African Americans (62%) accepted. Regression analysis determined that Mini‐Cog™ scores were associated with older age (β* = ‐0.255, SE = 0.02, p<.05) and being African American (β* = ‐0.261, SE = .344, p<.05) but not with sex, ethnicity, or living alone.ConclusionResults show that 25% of participants were identified with previously undetected cognitive impairment and that trained social service providers can effectively administer the Mini‐Cog™ instrument to assess cognitive impairment. Large scale studies are needed to further evaluate use of the Mini‐Cog™ instrument in early detection of cognitive impairment in minority and economically vulnerable older adults in non‐clinical settings.

1006 How Insomnia Masked a Young Man's First Episode Psychosis

Abstract Introduction Sleep disturbance is a common sign across many mental health disorders. Particularly, insomnia is a frequent issue among patients with mood disorders. However, there is increasing evidence that suggests that sleep disturbance may be a risk factor for developing psychosis, or conversely, an early warning sign of psychosis. In this case report, we describe a young patient’s first episode of psychosis, which was masked by an initial presentation of insomnia, diagnosed as major depressive disorder, and the patient decompensated further until his psychosis was appropriately diagnosed and treated. Report of case(s) A 20-year-old African-American male was evaluated at a major tertiary hospital after he was found calling his mother while crying and speaking incoherently. He was eventually admitted there for two weeks with the diagnosis of Major Depressive Disorder, and discharged on Bupropion 300 milligrams(mg) daily for depression, with Quetiapine 50mg and Trazodone 100mg at night for sleep. Following discharge from this hospital, the patient’s psychiatric history was significant only for one additional outpatient psychiatry clinic visit at a major community hospital, where he was again diagnosed with Major Depressive Disorder, and prescribed Zoloft 25mg daily. The patient eventually presented to our hospital with reports of worsening depression, poor sleep, poor appetite, and more recently, increasingly bizarre behavior. The patient initially presented to the unit disorganized (nursing staff frequently described patient as looking "lost"), staring blankly at the walls, internally preoccupied and laughing inappropriately as if responding to internal stimuli. Patient had episodes of emotional outbursts with aggression and bizarre behavior that required emergent medication. The patient’s Bupropion was discontinued in favor of oral Risperidone, titrated up to 4mg twice daily. Patient’s symptoms, including his sleep, gradually improved with the single antipsychotic regimen, and was eventually discharged after returning to his baseline. Patient was also evaluated by a clinical psychology team who also supported the assessment of first episode of psychosis. Conclusion This case highlights the importance of evaluating sleep disturbances in accurately diagnosing mental disorders. Studies show sleep is an important risk factor in the precipitation of many mental illnesses, while sleep disturbances are also frequently resolved by treating the underlying mental illness. Support (if any)

African American Males Have More Distress During Cancer Treatment Than White Males.

African American (AA) males have a higher incidence and mortality rate for some cancers than other races and sexes, which could be associated with distress during treatment, medical mistrust, and health disparities. We hypothesize distress in AA males during treatment is higher than in other races and sexes. We assessed effect modification of moderate to severe (≥ 4) distress scores during cancer treatment by race and sex, age, and socioeconomic status (SES). National Comprehensive Cancer Network's distress thermometer (scale 0-10) and characteristics for 770 cancer patients were collected from a Philadelphia hospital. Variables included age, sex, race, smoking status, marital status, SES, comorbidities, mental health, period before and during COVID-19, cancer diagnosis, and stage. Descriptive statistics, chi-square tests, and t-tests were used to compare AA and White patients. Effect modification of ≥ 4 distress by race and sex, age, and SES were analyzed by logistic regression. A p value of ≤ .05 was significant, and 95% confidence intervals (CIs) were reported. On average, AA patients had a non-significant, higher distress score (4.53, SD = 3.0) than White patients (4.22, SD = 2.9) (p = .196). The adjusted odds ratio of ≥4 distress was 2.8 (95% CI [1.4, 5.7]) for AA males compared with White males. There was no significant difference between White and AA females, race and age, or race and SES. There was an effect modification of ≥4 distress by race and sex. AA males in cancer treatment had higher odds of ≥4 distress compared with White males.

Abstract #1408210: Glycogen Storage Disease Type III Presenting as Seizure in an African American Male

Glycogen is the stored form of glucose which serves as a buffer for glucose needs. It is formed in periods of dietary carbohydrate loading and broken down when glucose demand is high or dietary availability is low. The main role of glycogen in the liver is to store glucose for release to tissues that are unable to synthesize significant amounts during fasting. In the muscle, glycogen serves as the primary source of energy for high-intensity muscle activity by providing substrates for the generation of adenosine triphosphate. Glycogen storage diseases (GSD) are rare inborn errors of glycogen metabolism that result from mutations in genes involved in glycogen storage. The age of onset varies from in utero to adulthood. The most affected organs are the liver and muscle where glycogen is abundant. Liver manifestations include hypoglycemia and hepatomegaly while muscle manifestations include cramps, exercise intolerance, easy fatigability, and progressive weakness. GSD III is due to an abnormality in the Amylo-Alpha-1, 6-Glucosidase, 4-Alpha-Glucanotransferase (AGL) gene causing deficiency of the glycogen debrancher enzyme. It is inherited as an autosomal recessive trait. Estimated prevalence is 1:100,000. It is characterized by variable liver, cardiac muscle and skeletal involvement. GSD IIIa is present in about 85% of affected individuals and manifests with liver and muscle involvement. GSD IIIb is in about 15 % of affected individuals with liver involvement only. The patient was born to a 35-year-old African American mother at 38 weeks gestation. Labor and delivery were uncomplicated. Initial labs showed blood glucose of 38 mg/dl for which he was placed on a hypoglycemia protocol. Breastfeeding was started successfully with no more noted hypoglycemia and he was discharged home. At 11 months he was taken to the ER after a witnessed tonic clinic seizure. Blood glucose was noted to be 24 mg/dl. He was managed with hypoglycemia protocol and Pediatric Endocrinology team consulted. Labs showed elevated liver enzymes, creatinine kinase and cholesterol with ALP 1101 units/L, AST 1822 units/L, ALT 1148 units/L, CK 783 units/L, total cholesterol 223mg/dl, triglyceride 249 mg/dl and HDL 30 mg/dl. Abdominal US showed hepatomegaly and echo showed left ventricular and septal hypertrophy. GSD was suspected so genetic testing was done and showed 2 frameshift mutations in the AGL gene confirming GSD Type IIIa. He was started on a low carbohydrate high protein diet together with corn starch with minimal hypoglycemia episodes. He has been closely followed at the pediatric Endocrinology clinic and is now 17 years old. He has a DEXCOM continuous glucose monitor. Most recent labs show some improvement in liver enzymes and lipids. Both of his parents are positive for the GSD III trait. Unexplained hypoglycemia warrants a thorough work up as highlighted in this case. Most of the severe forms of GSDs are diagnosed in childhood but some mild forms can be diagnosed in adulthood. Both pediatric and adult endocrinologists should have sufficient knowledge on the diagnosis and management of GSDs.

Abstract #1401381: Rare Case of Asymptomatic Multiple Sclerosis Lesions in Hyperprolactinemia

Hyperprolactinemia is associated with established multiple sclerosis (MS) and MS progression/relapse. An association between hyperprolactinemia and asymptomatic MS lesions, also known as radiologically isolated syndrome (RIS), has not been reported. A 29-year-old African American man presented with gynecomastia during a primary care visit. Medical history included prediabetes, hypertension, and obesity. He denied galactorrhea, decrease in libido, blurred vision, fatigue, enlarged hands/feet, hyperpigmentation, depression, easy bruising, skin changes, polyuria, and any neurological symptoms. His physical exam was unremarkable except for bilateral gynecomastia and obesity. Laboratory results revealed elevated prolactin 30.6 ng/mL. Thyroid function test was normal. Magnetic resonance imaging (MRI) brain showed normal pituitary gland size with a 0.3-cm rounded hypo-enhancing region, enhancement of the left optic nerve, and areas of abnormal T2/FLAIR lesion involving the juxtacortical and subcortical white matter in the left temporal region. Enhancements in the right occipitotemporal region and a small juxtacortical lesion in the medial inferior left frontoparietal region were also observed. The patient was referred to endocrinology. His only complaint was fatigue, and physical exam was unremarkable. Repeat prolactin was higher than before at 78 ng/mL. TSH was elevated at 6.44 mIU/mL with a free T4 of 1.03 ng/dL. Labs including ANA, AQP 4, Lyme, HIV, JC virus, and syphilis panel were negative. He was started on cabergoline 0.5 mg twice weekly for treatment of hyperprolactinemia. He was also started on levothyroxine for fatigue, which was attributed to subclinical hypothyroidism. Neurology initiated treatment for MS with diroximel fumarate. Follow-up in 2 months showed a prolactin level of 1 ng/mL and a normal TSH and free T4. The patient will be followed with MRI pituitary surveillance at 1 year and 5 years. This is a very rare case of hyperprolactinemia associated with RIS. The decision to treat the patient for MS was made to prevent or delay potential clinical symptoms or progression to overt disease. One study has noted a 34% risk of conversion of RIS lesions to the first clinical event of MS in 5 years, especially with risk factors like young age and male gender. However, it is still debatable whether RIS lesions progress and should be treated, given that medications used to treat MS are associated with possible side effects including allergic reaction. Follow-up will focus on presence of new neurological symptoms concerning for MS and change in the size of the pituitary lesion.

Giants in the Frame: A 1964 Photo Analysis of How Malcolm X and Dr. Harry Edwards Connected Race, Religion, and Sport

Racial analysis of photography in the canon is important when unpacking layers of racial discrimination, Black manhood, and the historical dynamics within social forces that create stereotypical perceptions of African American males. Race, religion, and sport allow scholars to unpack the perceived disposability of Black lives in contemporary society. In an effort to fully understand how sport and religion inform racialized experiences in Black manhood, the current paper seeks to advance theories of visual and racial culture in a particular context. Contextual analysis of a 1964 photograph of Malcolm X and Dr. Harry Edwards synthesizes the visual turn and offers insight into how race, sport, and religion collide to raise minority pride. A contextual analysis accounts for the ways in which visual materials function within broad social ecologies of Black masculinity. Implications are discussed for the role of sport and religion in continuing activism for racial equality.

Factors That Promote the Academic Success of Disadvantaged Students

This paper discussed the factors that hinder academic achievement of African American males from disadvantaged backgrounds with emphasis on Mississippi. These factors are applicable to other disadvantaged students from the same backgrounds. The factors originate from homes, individuals, communities, and schools. In addition, the paper proffered what African American males from disadvantaged backgrounds can do to overcome home, individual, community, and school factors that increase the odds of dropping out of school. The paper concluded that the causes of disadvantaged African American males dropping out of school originate from many sources. Finger pointing can only exacerbate the problem. Therefore, all stakeholders should work together to minimize or eliminate the problem of dropout for disadvantaged African American males and others from similar backgrounds in the Unites States and other regions of the world.

Lipidomic Profiling Reveals Biological Differences between Tumors of Self-Identified African Americans and Non-Hispanic Whites with Cancer.

In the US, the incidence and mortality of many cancers are disproportionately higher in African Americans (AA). Yet, AA remain poorly represented in molecular studies investigating the roles that biological factors might play in the development, progression, and outcomes of many cancers. Given that sphingolipids, key components of mammalian cellular membranes, have well-established roles in the etiology of cancer progression, malignancy, and responses to therapy, we conducted a robust mass spectrometry analysis of sphingolipids in normal adjacent uninvolved tissues and tumors of self-identified AA and non-Hispanic White (NHW) males with cancers of the lung, colon, liver, and head and neck and of self-identified AA and NHW females with endometrial cancer. In these cancers, AA have worse outcomes than NHW. The goal of our study was to identify biological candidates to be evaluated in future preclinical studies targeting race-specific alterations in the cancers of AA. We have identified that various sphingolipids are altered in race-specific patterns, but more importantly, the ratios of 24- to 16-carbon fatty acyl chain-length ceramides and glucosylceramides are higher in the tumors of AA. As there is evidence that ceramides with 24-carbon fatty acid chain length promote cellular survival and proliferation, whereas 16-carbon chain length promote apoptosis, these results provide important support for future studies tailored to evaluate the potential roles these differences may play in the outcomes of AA with cancer.

Association between Multiple Myeloma and Ulcerative Colitis: A Cross-Sectional Analysis

Multiple myeloma (MM) is a plasma cell dyscrasia that is common among patients with autoimmune diseases. However, the association between ulcerative colitis (UC) and multiple myeloma (MM) is yet to be established. We aimed to evaluate the prevalence of MM among patients with UC in the United States. This cross-sectional cohort analysis used the National Inpatient Sample from 2015-2018 to assess the overall MM prevalence among patients with and without UC, and within specific demographic subgroups. Prevalences were compared using a logistic regression model controlling for sex and age. The crude prevalence of MM among patients with UC (n = 1750) compared with patients without UC (n = 366,265) was 0.44% vs. 0.37%, respectively. Patients with UC had increased overall odds of having MM (odds ratio (OR), 1.26). Males with UC had higher prevalence of MM (53.7% vs. 46.3%, respectively) than females. Patients with UC and MM were more likely to be African American than White (15.6% vs. 9.2%, respectively). Patients with UC age >64 had a higher prevalence of MM than those aged below 65 (70.9% vs. 29.1%, respectively). Patients with UC who were obese (BMI > 30) had a higher prevalence of MM than those who were non-obese (12.6% vs. 8.3%). Overall, UC appears to be associated with MM. This association can be particularly observed in specific demographic groups, such as obese, African American males, or patients >64 years of age. Thus, a high degree of clinical suspicion for MM is warranted, even with minimal symptomatology, in patients with UC, in particular among elder, obese, and African American males.

The Dreamwork of the Symptom: Reading Structural Racism and Family History in a Drug Addiction

A key tenet of critical health research is that individual symptoms must be considered in light of the social and political contexts that shape or, in some cases, produce them. Precisely how oppressive social forces give rise to individual symptoms, however, remains challenging to theorize. This article contributes to debates over the interpretation of symptoms through a close reading of the case of Leon, an African American man struggling with an addiction to crack cocaine. Leon presented a complex illness narrative in which his addiction was clearly a product of structural racism, but also the result of dynamics within his family. Drawing on critical reevaluations of Freud’s concept of the dreamwork, I call attention to the surface elements of Leon’s narrative—what I term the surface of the symptom—and to the formal mechanisms by which latent contents (such as the social, the political, and the personal) are transformed into the manifest form of his symptom. This formal mode of reading offers a productive way of approaching questions of demystification and interpretation, one that holds in tension the register of social causation with the singularities of individuals and their symptoms.

When They Saw Me

The current project is an autoethnographic narrative account of memorable moments that affected (and, one might argue, effected) elements of the author’s identity as an African American man. The project includes several autobiographical anecdotes that span over four decades and include interactions with educators, relatives, and strangers. The author reconsiders the ways in which others’ perceptions of him, often linked to race, have affected his lived experiences in school, at work, on a summer afternoon walk, and online. Taken together, the anecdotes illustrate ways in which the social construction of race affects the author’s perception of self and others.