Quality Care Improvement Program in a Community-Based Participatory Research Project

Posted by James

diabetes tream

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.

Read the rest of this entry »

Bronchioloalveolar Carcinoma in African Americans: DISCUSSION

Posted by James

bronchioloalveolar carcinoma

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.

Read the rest of this entry »

Bronchioloalveolar Carcinoma in African Americans: RESULTS

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.

Read the rest of this entry »

Bronchioloalveolar Carcinoma in African Americans: PATIENTS AND METHODS

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.

Read the rest of this entry »

Bronchioloalveolar Carcinoma in African Americans

Posted by James

lung cancer

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).

Read the rest of this entry »

IDDM2 and the Polymorphism of the Human Tyrosine Hydroxylase: DISCUSSION

Posted by James

This report uses the microsatellite repeats (TCAT)n on chromosome 11 to investigate the tyrosine hydroxylase gene as IDDM2, the second major candidate gene for susceptibility to type-1 diabetes. No significant association was found either at the allele level or at the genotype level. This data is in contrast with findings in previous association studies that detected a significant association of hTH with type-1 diabetes in Caucasians. The data reported here for African Americans was consistent with findings reported by Field and coworker in a family study that failed to demonstrate significant evidence of linkage between type-1 diabetes and hTH, either by lod score or affected sibling pair linkage analysis. No association was found with hTH in another study that used restriction fragment polymorphism. The exact localization of the IDDM2 and the depiction of its effect on the expression of hTH, INS, and IGF2 may prove to be important in understanding the biological mechanisms that lead to the onset of type-1 diabetes and its complications. The study of microsatellite sequences has shown that they may have a function in recombination, in the generation of nucleosome positioning signals, and more subtle effects on expression. Previous studies have shown that hTH tetranucleotide repeat acts as a transcriptional enhancer in vitro. Moreover, these repeated sequences interact specifically and with high affinity with nuclear proteins.

Read the rest of this entry »

IDDM2 and the Polymorphism of the Human Tyrosine Hydroxylase: RESULTS

Posted by James

Five alleles were identified in this African-American population in the Washington, DC area labeled K5 (244 bp), K4 (248 bp), КЗ (252 bp), K2 (256 bp), and Kl (260 bp) (Table 2). The allele frequencies of the five alleles were estimated from 196 chromosomes of unrelated controls and 96 chromosomes of type-1 diabetes individuals. The heterozygosity of the TCAT marker was larger than 0.75. The most fre­quent allele of the hTH microsatellite repeats was K5 (248 bp), with a frequency 0.62 in controls and 0.66 in type-1 diabetes patients, which was not significantly different. The largest allele (260 bp) showed the greatest difference in allele frequency between patients and controls.

Read the rest of this entry »

About

    So Many Advances in Medicine, So Many Yet to Come