Que Sera? Sera?. Elizabeth Lee-Rey, MD Luz Towns-Miranda, PhD Hispanic Center of Excellence Albert Einstein College of Medicine. Que Sera? Sera?. OBJECTIVES To obtain an overview of demographic representation of Latinos nationally and locally in NYC and the Bronx.
Elizabeth Lee-Rey, MD
Luz Towns-Miranda, PhD
Hispanic Center of Excellence
Albert Einstein College of Medicine
Percent of boys with no regular MD
The Commonwealth Fund Survey of the Health of Adolescent Girls, 1997 Louis Harris and Associates, Inc
Source:NYC Depart of Planning
Presentation by NYC Major’s Off of Health Service
Presentation by the NYC Mayor’s Office of Health Services
Presented by the NYC Mayor’s Office of Health Services
b) Heart Disease
Source: The seventh Annual Hispanic Federation Annual Survey
Hispanic New Yorkers on Nueva York
Report 4:Latinos and HIV/AIDS
In fact, most of the 44 million uninsured Americans:
SOURCE: Hall, Collins, and Glied, 1999
The Commonwealth Fund
Collins, Hall, and Neuhaus, U.S. Minority Health: A Chart Book, 1999
Source:Therrien & Ramirez 2000 The Hispanic population in the US:3/2000 US Bureau of Census for Labor Statistics 3/99
% 0 25
Source: Day,J.C. 1996 Population projection for the US by age,sex,race,and Hispanic origin:1995-2050
Source Data for 2005:Population projections program, US census
Source:Project HOPE Center for Health Affairs-Dec 2000 Current Population Survey
Source:Therrien, M.,& Ramirez,RR 2000. The Hispanic Population in the US: March 2000
SOURCE: NYC Depart of Planning
Presented by the NYC Mayor’s Office of Health Service
History offered by patient and daughter.
Exam revealed an Overweight, Hispanic woman who appeared much older than her stated age.
VSS- T98.7 BP 170/100, repeat 168/ 90 HR 70
HEENT- Fundi cotton wool spots noted and changes consistent with HTN retinopathy
PERRLA- fair dentition with upper dentures
Neck- Supple, No neck masses, No bruits noted
Lungs- Mild upper airway rhonchi, no rales or wheezes noted. Adequate inspiratory effort noted
Cor- Distant heart sounds, mild 2/6 systolic ejection murmur at apex.
Breast Firm, discrete, irregular 2x4 cm, nontender mass palpated in LUQ Left breast.
Left Axillary node palpated-mildly tender
Abd Obese, nontender with no HSM or masses noted No abd bruits noted
Ext Limited ROM with crepitus of knees noted when getting on and off exam table, 1+ edema with
varicosities bilaterally. Without skin breakdown or fissue
Of evidence of infection. UE arthritic changes noted bilaterally
Neuro Cranial nerves intact. Monofilament testing revealed sensory deficits bilaterally
Medications: Allergies- NONE
Atenolol 50 mg po qd Tobacco 30 yr/pack
HCTZ 25 mg po qd Quit 10 years ago
Zocor 100mg po qd
Metformin 500mg po qd
ASA 81mg po qd
Una de gato
Hoja de Tilo
Hoja de naranja Agria
Flores de Coco Indio
Anis de Estrella
Given what what you have just learned about Latino health:
Patient went for mammogram, which indeed revealed breast mass as palpated by patient and confirmed by MD. Subsequently, needed special views, ultrasound of the area and an excisional biopsy was ordered. Pathology revealed a fibroadenoma. No evidence of malignancy. Annual mammograms with monthly SBE were recommended. Pt with positive family history will require surveillance. Diabetes and Arthritis no active issues. Remain stable and are monitored on following visits.
After several visits patient revealed that she had believed that a mass found in her breast meant cancer and that meant death. It was in” la manos de dios” and so had not needed attention. Patient had met with the local cuidrandero and had been going for banos. Patient starts to come to her visits unaccompanied by daughter. Daughter schedules appointment with provider.