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PURPOSE. This study was undertaken to determine if a community screening program designed to overcome key barriers (lack of awareness, cost of program, ease of access to care) could successfully impact on African-American males' knowledge, attitudes, and behaviors regarding prostate cancer screening. The focus of this report is knowledge. To date, there are no reported studies that examine differences in knowledge from a prescreening baseline to a postintervention level for minority participants. PATIENTS AND METHODS. A total of 944 men were enrolled in the study in a 20-month period. Prostate screening and education were offered as a new service at an existing senior health clinic. In addition, mass screenings were offered approximately monthly at various locations in the community (including senior community centers, senior apartment complexes, and some public housing projects). Screening included both the digital rectal examination and the prostate specific antigen test. A brief questionnaire was administered during client intake (the pretest) and repeated after the education and screening participation (the posttest). Test items targeted three constructs: (1) etiology, (2) risk status, and (3) clinical factors. RESULTS. The largest difference on pretest scores between the racial group's resulted from clinical factor knowledge. African-American men were significantly less likely than Caucasian men to correctly identify early symptoms of prostate cancer and the basic components of a prostate checkup. Although scores were initially significantly lower for African-American participants, these differences were not evident after program involvement. There was a significant increase in knowledge level for all men when comparing pretest and posttest scores. Significant improvement was noted for each test item, with the exception of one key item. Even after participation in the program, African-American men were stiff more likely to believe that 'pain' was die first symptom of prostate cancer. DISCUSSION. An itern-by-item analysis revealed that there was only one test item in which program participation did not 'correct' knowledge. African-American men were stiff more likely to believe that pain was the first symptom that would alert them to the presence of cancer. The screening program included information (both printed and oral content) that emphasized the importance of routine screening to detect cancer at an early stage, because most men would experience no symptoms. The only other reported study that examined knowledge documented similar findings with respect to an understanding of symptomology. These findings can be used to direct or guide the educational component of future screening programs that hope to target African-American men. [ABSTRACT FROM AUTHOR]

Abstract: With increasing use of golf carts and low speed vehicles (LSV) for recreational, work-related, and commuting purposes, the number of related injuries is also on the rise. The body of literature describing these injuries is informative but limited. From this scoping review, we found that, LSV related injuries preferentially affect children, older adults, and males. Common mechanisms of injury include ejection and collision. Associated alcohol consumption is common and typically related to increasing severity of injury. Various injuries may result from LSVs as described in the review, including soft tissue injuries, orthopedic injuries and TBI. Description of trends and classifications of injury will hopefully improve reporting and ability to make recommendations on safe use and regulation., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Severe acute respiratory syndrome coronavirus 2, also known as coronavirus 2019 (COVID-19), has impacted the lives of many older individuals, with those with comorbidities having the highest risk of severe disease. Specifically, immunosuppression and chronic obstructive pulmonary disease are two important risk factors. This case report describes the rehabilitation course of a 62-yr-old woman with a history of a double lung transplant for chronic obstructive pulmonary disease in 2016 who contracted a severe COVID-19 infection. After nearly a month in the intensive care unit, she underwent a 10-day course of inpatient rehabilitation and regained substantial independence and was able to return home only needing supervision. Although other cases in the rehabilitation literature have documented successful rehabilitation after COVID-19 infection, this transplant-related case required intensive coordination of care to meet goals and achieve success for the patient. Because of the limited numbers of studies, this information may prove valuable in future considerations for candidates of inpatient rehabilitation., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Prediction of short-term survival probability is important in the selection and allocation of patients for liver transplantation, and the Mayo End-Stage Liver Disease (MELD) score has been used in these contexts. The aim of this study was to develop and validate a model for estimation of short-term prognosis of patients selected for elective liver transplantation in the United Kingdom., Methods: A modeling dataset was based on 1103 adult patients registered for a first elective liver transplant in the United Kingdom between April 1, 2003, and March 31, 2006, and a validation dataset based on 452 patients registered between April 1, 2006, and March 31, 2007. The final model (United Kingdom End-Stage Liver Disease) included international normalized ratio, serum creatinine, bilirubin, and sodium., Results: The model, based on the modeling dataset, accurately predicted mortality on the transplant list in the validation dataset and proved to be a better predictor than MELD or MELD-Na. The United Kingdom End-Stage Liver Disease score was not associated with overall posttransplant survival but was associated with both the duration of intensive care unit stay and overall initial hospital stay., Conclusion: This model, developed specifically for patients awaiting liver transplantation, provides a useful tool for the selection of patients for liver transplantation and the allocation of donor livers.

Objective: To compare the left ventricular (LV) ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) from electrocardiogram-gated computed tomography (CT) to gated single-photon emission computed tomography (SPECT)., Methods: Fifty-seven patients underwent electrocardiogram-gated multidetector CT and SPECT examinations within a 3-month period, without interim cardiac events. The LV EF, EDV, and ESV were compared., Results: There was an excellent correlation between LV EF obtained from CT (60.25% +/- 12.93%) and SPECT (61.90% +/- 14.93%) (r = 0.81), with no significant difference (P = 0.17). Computed tomography-derived EDV and ESV correlated well with SPECT (r = 0.88 and 0.94, respectively). The EDV from SPECT (132.21 +/- 67.10 mL) was significantly lower than that from CT (147.53 +/- 55.03 mL; P = 0.0007); there was a trend for ESV from SPECT (58.39 +/- 61.20 mL) to be lower than that from CT (63.79 +/- 53.58 mL; P = 0.055). The EF, EDV, and ESV correlation of SPECT with the 64-row multidetector CT was better (r = 0.87, 0.89, and 0.96, respectively) than that with the 16-row CT (r = 0.36, 0.66, and 0.49, respectively)., Conclusions: There is a good correlation between LV EF, EDV, and ESV from gated SPECT and CT (particularly the 64-row CT). The LV volumes are lower on SPECT than on CT.

We tested the hypotheses that vascular cell adhesion molecule-1 (VCAM-1) expression on endothelium at lesion-prone sites in the rabbit aorta correlates with exposure to plasma cholesterol and that macrophage accumulation is associated with endothelial cells expressing VCAM-1. After rabbits were fed 0.25% cholesterol for 2 weeks, VCAM-1 expression was selectively increased at the distal and lateral portions of the major abdominal branches. In the arch and the celiac, superior mesenteric, and renal artery branches, VCAM-1 expression was positively correlated with the plasma cholesterol integrated over the duration of the experiments. After 2 weeks of cholesterol feeding, more macrophages were present around distal and lateral portions of the intercostal arteries and major abdominal branches relative to nonbranch regions. In the arch and around the intercostals and major abdominal branches, macrophage densities were positively correlated with the integrated plasma cholesterol. VCAM-1 and macrophage levels were correlated in lesion-prone regions. In normocholesterolemic rabbits, 23+/-4% (mean+/-SEM) of the macrophages were directly associated with VCAM-1-positive endothelium. After 2 weeks of 0.25% cholesterol feeding, the association increased to 37+/-4% (P<0.015). Associations were highest around the lateral and distal regions of the major abdominal branches. These results suggest that (1) VCAM-1 expression and intimal macrophage densities are influenced by plasma cholesterol and regional factors such as arterial fluid dynamics and (2) VCAM-1 plays a significant role in the localization of macrophages.

Lawn-care herbicides are a type of pesticide regulated under federal and state pesticide legislation. The Michigan Department of Agriculture implements herbicide regulation to protect the public's health and welfare. Yet, due to gaps that exist in all levels of government in the regulation of lawn-care herbicide application, the public is placed at risk. The federal pesticide legislation (Federal Insecticide, Fungicide, and Rodenticide Act) provides for a lower standard of safety in the classification of herbicides applied in the residential context as opposed to the agricultural context. Michigan legislation (The Pesticide Control Act) exempts from the law persons applying general herbicides on their own premises. The state does not require public notification of risks or safety precautions prior to commercial application of these herbicides. Furthermore, on-site inspections are not performed for residential application of herbicides and the state applicator certification program is not assessed for effectiveness.