Outcomes of the "BRCA Quality Improvement Dissemination Program": An initiative to improve patient receipt of cancer genetics services at five health systems.

Objective: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).

Methods: QII activities occurred at sites over several years, all concluding by December 2020.

Implementation and outcome evaluations of a multi-site improvement program in cancer genetics.

Program evaluation can identify the successes and challenges of implementing clinical programs, which can inform future dissemination efforts. A cancer genetics improvement program, disseminated from the Lead Team's institution to five health systems (Participating Sites), was genetic counselor led, using virtual implementation facilitation to support Participating Sites' performance of quality improvement (QI) activities over several years. Program implementation and outcome evaluations were performed and included evaluation of program delivery and initial effects of the program on Participating Sites.

Developmental changes in voltage-gated calcium channel α(2)δ-subunit expression in the canine dorsal root ganglion.

The voltage-gated calcium channel subunit α(2)δ plays a fundamental role in propagation of excitatory signals associated with release of glutamate and neuropeptides substance P (SP) and calcitonin gene-related protein (CGRP). It can be selectively inhibited by gabapentinoids. Hence, investigation of the α(2)δ subunit may predict the efficacy of gabapentinoid therapy in neuropathic pain.

Hereditary ataxia in the Jack Russell Terrier--clinical and genetic investigations.

Hereditary ataxia in the Jack Russell Terrier (JRT) is characterized by a gait disturbance with symmetric generalized ataxia and hypermetric and spastic movements. Histopathology shows a disease of the entire central nervous system, predominantly an axonopathy. In the present study, 35 clinically affected dogs were examined.

Eccrine porocarcinoma.

Eccrine porocarcinoma, a malignancy of the eccrine sweat glands, is extremely rare. Our report and a review of the literature (70 cases) emphasize the features of this tumor. Age at time of treatment ranged from 19 to 94 years (mean 67 years).

The impact of mammography on breast biopsy.

To determine the efficacy of mammography in the detection of early breast carcinoma at an urban teaching hospital, the results of all breast biopsies performed between 1983 and 1987 that were preceded by mammographic examination were retrospectively reviewed. There were 503 women in this population. Malignancy was detected in 79 cases (15.

Gastroduodenal polyps in familial adenomatous polyposis.

A retrospective review of the medical records of 30 patients with familial adenomatous polyposis who underwent oesophagogastroduodenoscopy was performed to evaluate the spectrum of gastroduodenal polyps. Twenty-five patients (83%) had gastroduodenal polyps. Eighteen patients (60%) had gastric polyps and 21 patients (70%) had duodenal polyps.

Chiari network entrapment of thromboemboli: congenital inferior vena cava filter.

Pulmonary emboli and a right atrial thrombus enmeshed in a Chiari network developed concurrently in a 69-year-old man. The network perhaps functioned as an inferior vena cava filter preventing massive pulmonary embolus. Chiari network should be considered in the differential diagnosis of a right atrial mass and the presence of pulmonary emboli should suggest surgical removal.

Breast biopsy. Changing patterns during a five-year period.

The current emphasis on early detection of breast carcinoma prompted an analysis of all breast biopsies performed at an urban teaching hospital between January 1, 1983, and December 31, 1987. There were 1,342 biopsies during this interval in 933 patients with an overall mean age of 45.3 years.