Lobular carcinoma of the breast with gastrointestinal metastasis.

We present the case of a 74-year-old woman with metastatic lobular carcinoma with an occult breast primary presenting as a suspected ampullary tumor due to its ampullary metastasis. The patient's clinical presentation is of interest in two aspects. First, lobular carcinoma of the breast metastatic to the ampulla is extremely rare.

Model for the cost-efficient delivery of continuous quality cancer care: a hospital and private-practice collaboration.

Cancer care is expensive due to the high costs of treatment and preventable utilization of resources. Government, employer groups, and insurers are seeking cancer care delivery models that promote both cost-efficiency and quality care. Baylor University Medical Center at Dallas (BUMC), a large tertiary care hospital, in collaboration with Texas Oncology, a large private oncology practice, established two independent centers that function cooperatively within the Baylor Charles A.

Lifestyle, genes, and cancer.

It is estimated that almost 1.5 million people in the USA are diagnosed with cancer every year. However, due to the substantial effect of modifiable lifestyle factors on the most prevalent cancers, it has been estimated that 50% of cancer is preventable.

Physical activity as a negative modulator of estrogen-induced breast cancer.

Physical activity is a protective factor for breast cancer. Exposure to estrogen is an important determinant of breast cancer risk and exercise reduces estrogen levels, with the level of evidence being stronger for post-menopausal women. Possible mechanisms for estrogen induced breast cancer include increased breast epithelial cell proliferation, the metabolism of estrogen to genotoxic metabolites, such as DNA-adducts, and the silencing of tumor suppressor genes (TSGs) that have been implicated in breast carcinogenesis by inducing gene promoter hypermethylation, which is potentially reversible.

Progesterone receptor expression is a marker for early stage breast cancer: implications for progesterone receptor as a therapeutic tool and target.

We determined the association of estrogen receptor (ER) and progesterone receptor (PR) expression in invasive breast cancer with stage at diagnosis. Univariate analyses indicated that although ER and PR expression were inversely associated with grade (P<0.0001), only PR expression (P<0.

An ecological study of the association of metal air pollutants with lung cancer incidence in Texas.

Background: Air pollution particulate matter and tobacco smoke, which contain metals that are human lung carcinogens, are associated with lung cancer risk. We conducted an ecological study to examine the association of metal air pollutants with lung cancer incidence in Texas.

Methods: During the period 1995 to 2000, 81,132 lung cancer cases were reported in Texas.

Role of physical activity in modulating breast cancer risk as defined by APC and RASSF1A promoter hypermethylation in nonmalignant breast tissue.

Physical activity reduces breast cancer risk. Promoter hypermethylation of the tumor suppressor genes APC and RASSF1A, which is potentially reversible, is associated with breast cancer risk. We conducted a cross-sectional study in 45 women without breast cancer to determine the association of physical activity with promoter hypermethylation of APC and RASSF1A in breast tissue.

An ecological study of the association of environmental chemicals on breast cancer incidence in Texas.

Purpose: To investigate the role of environment in breast cancer development, we conducted an ecological study to examine the association of releases for selected industrial chemicals with breast cancer incidence in Texas.

Methods: During 1995--2000, 54,487 invasive breast cancer cases were reported in Texas. We identified 12 toxicants released into the environment by industry that: (1) were positively associated with breast cancer in epidemiological studies, (2) were Environmental Protection Agency (EPA) Toxics Release Inventory (TRI) chemicals designated as carcinogens or had estrogenic effects associated with breast cancer risk, and (3) had releases consistently reported to EPA TRI for multiple Texas counties during 1988--2000.

The effect of environment on breast cancer risk.

Environmental factors are believed to explain a large proportion of breast cancer incidence. Known risk factors for breast cancer, which are related to the reproductive life of women, and other factors, such as inheritance and socioeconomic status, explain only about half of the breast cancer cases in the US. Ionizing radiation is a well established environmental risk factor for breast cancer.

Nutrient intake and diet quality in patients with systemic lupus erythematosus on a culturally sensitive cholesterol lowering dietary program.

Objective: To evaluate the effect of a culturally sensitive cholesterol lowering dietary program on energy, protein, fiber, vitamin and mineral intake, diet quality, and hemoglobin levels in patients with systemic lupus erythematosus (SLE).

Methods: Seventeen patients with SLE were randomized to a Step II diet intervention group or a control group for 12 weeks. The diet intervention was made up of weekly group sessions during the first 6 weeks followed by telephone counseling every 2 weeks for the last 6 weeks.

Effectiveness of Acute Asthma Care Among Inner-city Adults.

Background: Acute asthma often requires expensive emergency department visits and hospitalizations, especially among economically disadvantaged inner-city adults. However, few studies have examined approaches for improving acute asthma care in this population.

Methods: We conducted a cohort study involving patients who were discharged from a public hospital emergency department following acute asthma care between March 31, 1997, and August 5, 1999, to identify processes of care effective for improving peak expiratory flow rate at a 2- to 3-week follow-up.

Effect of a culturally sensitive cholesterol lowering diet program on lipid and lipoproteins, body weight, nutrient intakes, and quality of life in patients with systemic lupus erythematosus.

Objective: To evaluate the effect of a culturally sensitive cholesterol lowering diet program on lipid and lipoproteins, body weight, nutrient intakes, and quality of life (QOL) in patients with systemic lupus erythematosus (SLE).

Method: Seventeen patients with SLE were randomized to a Step 2 diet intervention group or a control group for 12 weeks. The diet intervention was made up of weekly group sessions during the first 6 weeks followed by telephone counseling every 2 weeks for the last 6 weeks.

Predictors of short-term clinical response to acute asthma care in adults.

Objective: We assessed the effects of potential patient risk factors on short-term clinical response to acute asthma care among adults who often require emergency department (ED) visits and hospitalizations to manage their asthma.

Design And Setting: Prospective cohort study that included adult patients treated for acute asthma, which was conducted in a US public hospital ED between March 1997 and August 1999, with a 2- to 3-week follow-up.

Study Participants: Three hundred and nine patients completed the study.