Posted by James
Process Outcome
Retention plan. The plan was evaluated by the annual number of contacts with primary care providers recorded on DC practice records. These contacts were defined as a continuous variable and used to assess the objective’s implementation by the DIRECT staff. Overall attendance at education events was monitored, but attendance of specific CQIP providers was not transcribed.
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Posted by James
The CQIP used a one-group pre- and post-test design. The target population included African-American residents of southeast Raleigh, the historical center of Raleigh’s African-American community. The DC component was initiated in August 1996; the ongoing intervention is at its institutionalization phase. The North Carolina State University, Wake Forest University, and CDC Institutional Review Boards approved Project DIRECT protocols during the study.
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Posted by James
INTRODUCTION
The complex set of health status determinants, the disproportionate disease burden experienced in marginalized communities, and the limited effectiveness of traditional prevention research, particularly in minority communities, have increased the demand for more comprehensive and participatory approaches to public health research and practice. In 1985, the Secretary of Health and Human Services Task Force on Black and Minority Health identified diabetes as a major contributor to mortality among minorities in the United States. To respond to the excessive, unnecessary burden of diabetes among African Americans, the Centers for Disease Control and Prevention (CDC) led the development, implementation, and evaluation of Project DIRECT (Diabetes Interventions Reaching and Educating Communities Together) in southeast Raleigh, NC.
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Posted by James
In our study, all patients were African Americans, therefore we had the opportunity to review the clinical and pathophysiological features of ВАС exclusively in this ethnic group. ВАС was the least common lung tumor in our series and accounted for only 3% of cases. This is in accordance with the literature reporting the incidence of ВАС at 1-9%. Women accounted for one-third of our patient population similar to the 40% of previously reported ВАС. ВАС is a unique pathological entity that is distinct from pulmonary adenocarcinoma. Although histological feaures may overlap, ВАС demonstrates a growth pattern along preexisting lung architecture without invasive or destructive growth. The association of ВАС with scarring has been recognized for years.
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Posted by James
Eight-hundred-thirty-five cases of lung cancers were diagnosed between 1984 and 1999 at this hospital. ВАС constituted 3% (27) of lung cancers and 10.5% of adenocarcinomas. The most common neoplasm was adenocarcinoma, accounting for 256 cases (30.7%) followed by squamous-cell carcinoma in 228 cases (27.3%), small-cell carcinoma in 88 cases (10.5%), large-cell carcinoma in 57 cases (6.8%) and other (including metastatic) carcinomas in 179 cases (21.4%). In other series in which ВАС was described separately, its incidence ranged from 1.1% to 6.5%. When described as subtype of adenocarcinoma, it accounted for 15-20% of cases.
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Posted by James
This is a retrospective review of 19 cases of ВАС at Howard University Hospital between 1984 and 1999. Twenty-seven cases were identified during this period. Medical records of 19 patients were available for review. All the diagnoses had been determined by biopsy of specimens obtained by resection of lesion or transbronchial biopsy or CT-guided needle biopsy. The pathological reports were reviewed. Patient ages ranged from 49-89 years (average 63 years). All 15 men and four women were African Americans (Table 1). The cases were reviewed and the following information extracted: age at diagnosis, smoking history, occupation, previous pulmonary disease, symptoms, chest X-ray and CT scan, method of diagnosis, treatment, response to treatment, and survival time from the time of diagnosis. Institutional review board approval was obtained. The results of this study were statistically compared with the study by Feldman et al., which consisted of a mainly Caucasian population. Fisher exact test was used for statistical analysis. A p-value of <0.05 was considered statistically significant.
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Posted by James
INTRODUCTION
Lung cancer is the leading cause of cancer related deaths in the United States among both men and women. There were 164,100 new cases and 156,900 deaths estimated for 2000. Nonsmall-cell lung cancer accounts for 80% of all cases, with the remaining 20% presenting as small-cell cancer. Adenocarcinomas are subdivided histologically into four subtypes; acinar, papillary, mucinous, and bronchio-alveolar carcinoma (ВАС).
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