Project ECHO Brain Health: Assessing the Impact of a Pilot Program to Promote Self-Efficacy Among Community Health Workers.

This mixed-methods study sought to examine the impact of the Project ECHO Brain Health program on participating community health workers' (CHWs') self-efficacy to address dementia, promote brain health, and advocate for research among Latinx South Texas communities. Using an explanatory sequential design, quantitative data collected from pre- and post-program surveys were analyzed to inform the collection of qualitative data, followed by an interpretation of all findings to better understand the impact of the program on self-efficacy. Pre- and post-surveys were collected from 25 CHWs, 13 of whom later participated in individual interviews.

Community Health Worker-Led mHealth-Enabled Diabetes Self-management Education and Support Intervention in Rural Latino Adults: Single-Arm Feasibility Trial.

Background: Latinos living in rural South Texas have a higher prevalence of diabetes, but their access to diabetes self-management education and support (DSMES) is limited.

Objective: We aimed to test the feasibility of a community health worker-led, mobile health (mHealth)-based DSMES intervention to reduce disparities in accessing DSMES in underserved rural Latino residents in South Texas.

Methods: This 12-week, single-arm, pre-post trial was delivered by trained community health workers to 15 adults with type 2 diabetes.

Clinical inquiries. Do nonmedicated topicals relieve childhood eczema?

Emollients are effective first-line treatment to decrease symptoms of eczema and reduce the need to use steroids in children. Tar preparations work, but compliance may be limited. Gamma-linoleic acid preparations, borage oil, and evening primrose oil show efficacy in small studies.

Large cell neuroendocrine tumor of the cervix and human papillomavirus 16: a case report.

Background: Large cell neuroendocrine cancer of the cervix is a rare entity. Most cervical cancers are high-risk human papillomavirus (HPV)-related neoplasms.

Case: A 31-year-old woman presented with pelvic pain and daily vaginal bleeding for 6 months.

Residency training in pyloromyotomy: a survey of 331 pediatric surgeons.

Purpose: Both pediatric and general surgeons perform pyloromyotomy. Laparoscopic pyloromyotomy (LAP), and changes in referral patterns have affected the training of pediatric surgery fellows and general surgery residents. We surveyed pediatric surgeons regarding these issues.

Pharmacist privileging in a health system: Report of the Qualified Provider Model Ad Hoc Committee.

Purpose: The rationale for and steps of pharmacist credentialing and privileging are described.

Summary: As pharmacy evolves to include direct patient care, health care organizations are under increasing scrutiny to verify that their pharmacists are not only licensed to practice but are capable providers of direct patient care. Credentialing is a process conducted by a health care organization to review and verify a pharmacist's credentials.

A bridge between academic and community radiation oncology treatment planning.

Purpose: To evaluate Telesynergy (TS) as a method of interactive treatment planning between academic and community radiation oncology departments.

Methods: Through a grant from the National Cancer Institute to improve cancer outcomes for underserved populations, community radiation oncologists at New Hanover Regional Medical Center (NHRMC) in Wilmington, North Carolina, partnered with those at the University of North Carolina (UNC) in Chapel Hill, North Carolina. TS suites were installed at both sites to facilitate teleconferencing and review of treatment planning for intensity-modulated radiation therapy (IMRT).

One-year follow-up of very preterm infants who received lucinactant for prevention of respiratory distress syndrome: results from 2 multicenter randomized, controlled trials.

Background: The benefits of exogenous surfactants for prevention or treatment of respiratory distress syndrome are well established, but there is a paucity of long-term follow-up data from surfactant-comparison trials.

Objective: We sought to determine and compare survival and pulmonary and neurodevelopmental outcomes through 1 year corrected age of preterm infants who received lucinactant and other surfactants in the SELECT (Safety and Effectiveness of Lucinactant Versus Exosurf in a Clinical Trial) and STAR (Surfaxin Therapy Against Respiratory Distress Syndrome) trials individually and, secondarily, from analysis using combined data from these 2 trials.

Methods: All infants from both trials who were randomly assigned to administration of lucinactant (175 mg/kg), colfosceril palmitate (67.

Animal-derived surfactants versus past and current synthetic surfactants: current status.

In this review, the authors assess major outcomes resulting from head-to-head comparison trials of animal-derived surfactants with previous and newer synthetic surfactants and among them. They also pay special attention to issues of study design and quality of the trials reviewed. Animal-derived surfactants that contain surfactant proteins (Survanta, Infasurf, and Curosurf) perform clinically better than Exosurf, a synthetic surfactant containing only phospholipids, primarily in outcomes related to acute management of respiratory distress syndrome (RDS; faster weaning and pneumothorax) but not in overall mortality or incidence of bronchopulmonary dysplasia (BPD).

Hospital characteristics affect outcomes for common pediatric surgical conditions.

Appendicitis, hypertrophic pyloric stenosis (HPS), and intussusception are common conditions treated in most hospitals. In which hospital settings are children with these conditions treated? Are there differences in outcomes based on hospital characteristics? Our purpose was to use a nationwide database to address these questions. Data were extracted from Kids' Inpatient Database 2000.

A preliminary study of imiquimod treatment in variants of basal cell carcinoma.

Imiquimod is a topical immune response modifier that has proved efficacious in the treatment of the superficial variant of basal cell carcinoma. The nodular variant of basal cell carcinoma has shown moderate response to imiquimod; other variants have not been tested. The mechanism of action is largely unknown; however, studies indicate the mechanism involves alteration of local cytokine production.

Sarcoidosis mimicking recurrent endometrial cancer.

Background: Sarcoidosis is a multisystem disease and can be confused with benign or malignant tumors. In patients with recurrent gynecologic cancer, liver and intrathoracic lesions should undergo a biopsy to rule in metastatic malignancy, as clinical findings and CAT scan results may represent other disease processes.

Case: A 67 year old woman had a total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic and periaortic lymphadenectomy, and peritoneal cytology in 2001 for Stage I B grade 1 adenocarcinoma of the endometrium.

Evidence-based management of infants with congenital diaphragmatic hernia.

The mortality rate associated with congenital diaphragmatic hernia (CDH) varies widely between centers and remains relatively high despite widespread use of new therapeutic modalities. Many of these have been implemented without properly controlled studies. Over the past 10 to 15 years, only 9 randomized trials enrolling a total of approximately 250 infants with CDH have been published.

Local and national trends over a decade in the surgical treatment of ductal carcinoma in situ.

Background: Ductal cancer in situ (DCIS) is an increasingly frequent diagnosis in breast cancer, and management continues to challenge surgeons and oncologists. The purpose of our study was to examine local and national rates of breast conservation surgery and breast reconstruction surgery and to explore patient and surgeon factors associated with the procedures.

Methods: Review of the 1,342 patients in our institutional breast cancer database yielded 211 patients with DCIS.

A preliminary investigation of balloon angioplasty versus surgical treatment of thrombosed dialysis access grafts.

It has been estimated that 180,000 patients in the United States have end-stage renal disease requiring hemodialysis, and this number is currently increasing at a rate of 10 per cent per year. With the growing number of patients requiring hemodialysis the insertion and maintenance of dialysis access has become a common task for vascular surgeons. In fact dialysis access is now the most common vascular operation and may account for as much as 40 to 50 per cent of the practice of a busy vascular surgeon.

Gastric necrosis associated with acute gastric dilatation and small bowel obstruction.

Background: While acute gastric dilation is a postoperative complication familiar to most surgeons, massive dilatation with necrosis and rupture is a very rare event. We performed a computer search in the MEDLINE database for the years 1966-2001 for articles published in any language using the key words gastric dilation, gastric necrosis, intestinal obstruction, and gynecologic surgery. Our search yielded no reports of massive gastric dilation and ischemic necrosis from a small bowel obstruction following gynecologic surgery.

Squamous cell carcinoma arising in a dermoid cyst of the ovary.

Background: Unlike ordinary germ cell tumors of the ovary, squamous cell carcinoma arising in a dermoid affects elderly persons. Prognosis is poor when the disease has spread beyond the ovary.

Case: The case of a 67-year-old woman with stage III squamous cell carcinoma arising in a dermoid cyst of the ovary and extending to the serosa and myometrium of the uterus, pelvic peritoneum, the serosa, and muscularis of the distal ileum and penetrating entirely through the wall of the sigmoid is presented.