SUMMARY Twenty-six patients with Wolff-Parkinson-White (WPW) syndrome were studied by echocardiography. They were classified into the following WPW types: anterior right ventricular pre-excitation ( Since its recognition in 1930 there have been numerous reports of cardiac abnormalities associated with WPW. These include Ebstein's anomaly, tricuspid atresia, ventricular septal defect, atrial septal defect, coarctation of the aorta, corrected transposition of the great vessels, tetralogy of Fallot and idiopathic hypertrophic subaortic stenosis.9'0 The true incidence of these conditions associated with WPW is unknown.The purposes of this study were to utilize echocardiography to determine the motion of the interventricular septum in WPW, and to assess the incidence of cardiac abnormalities associated with the WPW syndrome. MethodsPatients were identified by reviewing the ECG files at the University of Iowa Hospital and Veterans Administration Hospital in Iowa City. Preliminary ECG criteria for identification were a P-R interval of less than 0.12 sec and a delta wave. No attempts were made to select patients by age, sex or cardiac diagnosis. All patients with at least one ECG meeting these preliminary criteria were contacted by letter and telephone; 26 responded and these were the subjects of the study.All 26 patients underwent physical examination, 12 lead scalar electrocardiography, Frank system vectorcardiog-

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Unusual ECG changes of marked ST segment elevation in leads V1 to V3 are reported in four cases of severe icteric leptospirosis for the first time. These changes normalized rapidly with initiation of therapy and recovery in three patients. One patient died within hours of admission. The causes for the changes are not clear.

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INTRODUCTION AND OBJECTIVE: Racial disparities are known to affect urologic care. Previous studies of Peyronie's Disease (PD) have investigated responses to treatment by race, but not treatment rates themselves. Frequently, racial disparities in healthcare are attributed to differences in income or decreased insurance rates among people of color. For this reason, we aimed to investigate racial disparities in PD treatments by evaluating the VA Informatics and Computing Infrastructure (VINCI), which contains data from the Veteran Health Administration (VHA). As veterans are insured and able to obtain treatment for PD through the VHA, this population allows us to study the effects of race on treatment rates when insurance does not serve as a barrier.METHODS: We queried VINCI to obtain data for a cohort of men that have a recorded diagnosis of PD by ICD-9 or ICD-10 code between 2015-2020. We then used the following CPT codes to identify which patients had procedures known to be therapeutic for PD: plaque injection (CPT 54200), penile prosthesis (54400, 54405), penile reconstruction to correct penis angle (54360), or plaque excision (54110, 54111, 54112). We evaluated treatment rates among patients with race/ethnicity information recorded. We reported results as frequencies and used the chi-square test to evaluate significant differences in treatment rates when comparing racial groups to Whites, with statistical significance reported at p<.05.RESULTS: We obtained data for 17,022 patients with diagnoses of PD. Within the total population of patients diagnosed with PD who had race and ethnicity information recorded, 62.0% were White (Non-Hispanic), 24.6% were Black, 9.6% were Hispanic or Latino, 1.8% were Asian or Pacific Islander (API), and 2.0% were Native American (NA). Among this cohort, 8.1% of all patients, 9.5% of Whites, 6.0% of Blacks (p<.05), 5.4% of Hispanics (p<.05), 6.6% of API (p<.05), and 3.7% of NA (p<.05) were treated.CONCLUSIONS: Within the VHA population, which is not limited by access to health insurance, all racial groups were treated for PD at a significantly lower rate than Whites. Further studies are warranted to investigate the etiologies of these disparities, which may be due to variations in disease severity, cultural factors, or societal barriers.