Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California.Methods: We analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people between 1995 and 2005. A third of the cohort was selected from high poverty neighborhoods. Hispanic enclaves and Mexican American (MA) barrios were neighborhoods where 40% or more of the residents were Hispanic or MA. Key analyses were restricted to poor neighborhoods.Results: Hispanic people were more likely to receive chemotherapy (RR = 1.18), especially men in Hispanic enclaves (RR = 1.33) who were also advantaged on survival (RR = 1.20). A survival advantage was also suggested among MA men who resided in barrios (RR = 1.80).Conclusions: The findings were supportive of Hispanic paradox and barrio advantage theories, further suggesting that such advantages are greater for men due to their greater familial supports.
A heterosexual man with acquired syphilis had an uncommon presentation in the form of acute visual loss. The unusual clinical presentation and a high cerebrospinal fluid lymphocyte count led to delayed diagnosis and treatment. Recognition of uncommon presentation of syphilis in the current epidemic is essential for the interruption of transmission.
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