The Effect of Two Church-based Interventions on Breast Cancer Screening Rates Among Medicaid-Insured Latinas

INTRODUCTION: Latinas face disparities in cancer screening rates compared with non-Latina whites. The Tepeyac Project aims to reduce these disparities by using a church-based approach to increase breast cancer screening among Latinas in Colorado. The objective of this study was to compare the effect of two Tepeyac Project interventions on the mammogram rates of Latinas and non-Latina whites enrolled in the Medicaid fee-for-service program. METHODS: Two intervention groups were compared: 209 churches in Colorado that received educational printed materials in Spanish and English (the printed statewide intervention) and four churches in the Denver area that received personalized education from promotoras, or peer counselors (the promotora intervention), in addition to the printed statewide intervention. Biennial Medicaid mammogram claim rates in Colorado before the interventions (1998–1999) and after (2000–2001) were used to compare the effect of the interventions on mammogram use among Latinas and non-Latina whites aged 50 to 64 years who were enrolled in the Medicaid fee-for-service program. Adjusted rates were computed using generalized estimating equations. RESULTS: Small, nonsignificant increases in screening were observed among Latinas exposed to the promotora intervention (from 25% at baseline to 30% at follow-up [P = .30]) as compared with 45% at baseline and 43% at follow-up for the printed statewide intervention (P = .27). Screening among non-Latina whites increased by 6% in the promotora intervention area (from 32% at baseline to 38% at follow-up [P = .40]) and by 3% in the printed statewide intervention (from 41% at baseline to 44% at follow-up [P = .02]). No significant disparities in breast cancer screening were detected between Latinas and non-Latina whites. After adjustment for the confounders by generalized estimating equations, the promotora intervention had a marginally greater impact than the printed statewide intervention in increasing mammogram use among Latinas (generalized estimating equation, P = .07). CONCLUSION: A personalized community-based education was only modestly effective in increasing breast cancer screening among Medicaid-insured Latinas. Education alone may not be the answer for this population. The barriers for these Medicaid enrollees must be investigated so that interventions can be tailored to address their needs

Hypertensive brainstem encephalopathy involving deep supratentorial regions: does only blood pressure matter?

We report on a 42-year-old female patient who presented with high arterial blood pressure of 245/150 mmHg and hypertensive brainstem encephalopathy that involved the brainstem and extensive supratentorial deep gray and white matter. The lesions were nearly completely resolved several days after stabilization of the arterial blood pressure. Normal diffusion-weighted imaging findings and high apparent diffusion coefficient values suggested that the main pathomechanism was vasogenic edema owing to severe hypertension. On the basis of a literature review, the absolute value of blood pressure or whether the patient can control his/her blood pressure seems not to be associated with the degree of the lesions evident on magnetic resonance imaging. It remains to be determined if the acceleration rate and the duration of elevated arterial blood pressure might play a key role in the development of the hypertensive encephalopathy pattern

Effect of Varying the Semiconducting/Metallic Tube Ratio on the Performance of Mixed Single-Walled Carbon Nanotube Network Gas Sensors

The sensing properties of mixed networks consisting of semiconducting and metallic single-walled carbon nanotubes (SWCNTs) have been found to largely vary depending on the ratio of semiconducting to metallic tubes. Solution-deposited 99% semiconductor-enriched nanotube networks exhibited a sensitivity of 1.908%/ppm, whereas the unenriched 66% and 90% enriched samples exhibited a sensitivity of 0.027%/ppm and 0.113%/ppm, respectively. These results suggest that it is extremely important to minimize the metallic pathways to achieve high sensitivity. After an oxygen plasma treatment, the unenriched 66% sample exhibited a 526% increase in sensitivity (0.142%/ppm) compared to the untreated one, whereas the 90% device demonstrated a sensitivity of 1.521%/ppm, which corresponds to an improvement in the sensitivity of 13.5 times the pristine 90% sample. In addition, the plasma-treated sensors exhibited a much faster response time than the untreated one. The significant improvement in the performance of the highly enriched network sensors was explained by the large increase in the anchoring sites for ammonia molecules on the surface of the semiconducting single-walled CNTs and the faster charge transfer from absorbed molecules

Size distributions of atmospheric particulate matter and associated trace metals in the multi-industrial city of Ulsan, Korea

Particulate matter (PM) was collected using micro-orifice uniform deposit impactors from a residential (RES) site and an industrial (IND) site in Ulsan, South Korea, in September-October 2014. The PM samples were measured based on their size distributions (11 stages), ranging from 0.06 ??m to over 18.0 ??m. Nine trace metals (As, Se, Cr, V, Cd, Pb, Ba, Sb, and Zn) associated with PM were analyzed. The PM samples exhibited weak bimodal distributions irrespective of sampling sites and events, and the mean concentrations of total PM (TPM) measured at the IND site (56.7 ??g/m3) was higher than that measured at the RES site (38.2 ??g/m3). The IND site also showed higher levels of nine trace metals, reflecting the influence of industrial activities and traffic emissions. At both sites, four trace metals (Ba, Zn, V, and Cr) contributed to over 80% of the total concentrations in TPM. The modality of individual trace metals was not strong except for Zn; however, the nine trace metals in PM2.5 and PM10 accounted for approximately 50% and 90% of the total concentrations in TPM, respectively. This result indicates that the size distributions of PM and trace metals are important to understand how respirable PM affects public health

A Surgically Treated Case of Chronic Necrotizing Aspergillosis with Pleural Invasion

Aspergillus is a ubiquitous fungus and can cause many levels of disease severity. Chronic necrotizing aspergillosis is a rare disease and few cases have been reported in Korea. We experienced a case of pleural aspergillosis that was treated successfully with medical and surgical interventions. The 52-year-old man who was diagnosed with chronic necrotizing pulmonary aspergillosis underwent surgical treatment including a lobectomy, decortication, and myoplasty. The patient was also medically treated with amphotericin B followed by voriconazole. Pleural irrigation with amphotericin B was also performed. A multi-dimensional approach should be considered for treating chronic necrotizing pulmonary aspergillosis