A stepped-wedge randomized trial protocol of a community intervention for increasing lung screening through engaging primary care providers (I-STEP).

Lung cancer screening with low-dose computed tomography (LDCT) reduces lung cancer mortality, yet few eligible high-risk patients receive it annually. This protocol describes a community-partnered intervention (Toolkit) designed to support primary care practices in making referrals for lung screening and guiding patients into appropriate screening pathways. This study uses a stepped-wedge implementation design.

Comparison of Cancer-specific and General Health Literacy Assessments in an Educated Population: Correlations and Modifying Factors.

An information onslaught accompanies cancer diagnoses, but patient comprehension (health literacy; HL) is frequently low, impacting both immediate care and longer term follow-up. Knowledge and adoption of preventive measures is especially important for cancer survivors due to their increased risk of secondary malignant neoplasms. We sought to evaluate the Test of Functional Health Literacy Adult (S-TOFHLA) against the recently developed cancer-specific Cancer Message Literacy Test (CMLT-r) among an educated population of both cancer survivors and those cancer-free.

Hyperemic maximal venous outflow unmasks symptomatic lower extremity venous obstruction.

Venous obstruction is an underappreciated and often unrecognized component of the pathophysiology of symptomatic chronic venous disease (CVD). Moreover, standard methods used to detect venous obstruction, such as maximal venous outflow, are inadequate as they typically test patients at rest and in the supine position when the pathophysiology of CVD is defined in the upright patient performing exercise. This report describes a patient with incapacitating venous claudication in whom standard noninvasive venous function tests were normal and whose phlebography was interpreted as showing no evidence of venous obstruction.

Lower extremity arterial inflow is adversely affected in patients with venous disease.

Background: Lower extremity chronic venous disease is due to venous hypertension resulting from reflux and/or obstruction. Studies of venous valvular function have validated and quantified valve closure times defining normal and abnormal valve function, and investigators have categorized the amount of venous reflux with validated criteria. However, hemodynamics of venous outflow obstruction remains poorly defined.