Resurrection Health Care

read as a whole or used as a go-to reminder of a cognitive map and strategies to manage these conversations.On our first reading, we found ourselves agreeing wholeheartedly with the book's recommendations, but we struggled to put them into day-to-day clinical practice or to remember its acronyms weeks later.Finding the time and focus to practice these skills is a heavy lift for a busy family physcian.However, this book also makes an excellent point-of-care resource to prepare for challenging patient or family encounters.We recommend that physicians in training and seasoned clinicians read this book and keep it close at hand as they gradually strengthen the practice of person-centered communication in the most difficult situations.

Abstract Introduction/Objective Tumefactive pulmonary amyloidosis is a rare variant of pulmonary amyloidosis characterized by the extracellular deposition of abnormal protein fibrils in the lung parenchyma, forming tumor-like masses called amyloidomas. Although most cases are clinically silent, it may present with findings that mimic a wide range of respiratory conditions (eg. primary or metastatic malignant nodules, granulomatous disease, multiple pulmonary hamartomas etc), thereby necessitating a comprehensive and broad-based approach to differential diagnosis. Methods/Case Report We present a case of an 88-year-old male with a history of smoking and multiple comorbidities. He presented with numerous bilateral pulmonary nodules identified on a CT scan, concerning for malignancy. A biopsy from a left upper lobe lesion revealed necrotic tissue and was non-diagnostic. A PET scan to assess for metastatic disease was unremarkable, and demonstrated mild hypermetabolic activity, confined to the lungs, with standardized uptake values (SUV) ranging from 4.3 to a maximum SUV of 8.9. A subsequent right lung biopsy was positive for amyloid, confirmed by Congo red staining. A Mass spectrometry analysis further identified the amyloid as AL type. Serum, and urine protein electrophoresis with immunofixation were negative for M protein and the serum free light chain assay was normal as well. Significantly, the bone marrow biopsy also yielded normal results, and the patient was diagnosed with a localized form of AL amyloidosis. Results (if a Case Study enter NA) NA Conclusion This case highlights how tumefactive pulmonary amyloidosis poses a diagnostic challenge due to its rarity and resemblance to malignancy on imaging. Careful histopathological examination, including immunohistochemical stains and amyloid typing, was pivotal in establishing the correct diagnosis and underscores the essential role of pathology and laboratory medicine in differentiating rare pulmonary conditions, along with the need for a multidisciplinary approach in complex diagnostic scenarios.

Evaluation of multiple community-based approaches to improve Latinas' breast cancer (BC) screening utilization has resulted in inconsistent findings. Factors contributing to this variation include heterogeneity in approaches (e.g., types of conceptual frameworks) and study quality (e.g., lack of measurement of spillover effects). This pilot study sought to clarify which approach may be most effective by evaluating the relative efficacy of two conceptual approaches using an area-level design with 145 Latinas nonadherent to U.S. Preventive Services Taskforce (USPSTF) BC screening guidelines. Each study arm included identical intervention format and duration (e.g., three group-based sessions, logistic assistance (LA) via five monthly calls and referral to free/low-cost screening programs). However, study content differed. While educate+LA addressed participants' BC prevention and screening behavior, empower+LA addressed participants' and their social networks' BC screening. After adjusting for age, insurance status, and baseline mammography intention, when compared with educate+LA participants, empower+LA participants were more likely to report obtaining mammograms, engaging more individuals about BC, initiating BC conversations in public settings, and discussing mammography specifically. Our study has important implications regarding the utility of evaluating behavioral interventions overall in terms of behavioral and spillover network effects.

We offer a framework and exemplify how to integrate multiple community perspectives in research to develop breast cancer screening interventions among Latinas non-adherent to national guidelines. We leverage members of an academic institution's community consultative service [community engagement advisory board (CEAB) members]; study team members [community health workers (CHWs)] and study-eligible individuals (non-adherent Latinas). First, we asked what was needed from CEAB members (N=17), CHWs (N=14) and non-adherent Latinas (N=20) in one-time semi-structured group consultations and focus groups. Second, we drafted materials. Third, we conducted group consultations and focus groups with a new set of CEAB members (N=13), CHWs (N=17) and non-adherent Latinas (N=16) to reflect on our initial analysis and draft materials. Fourth, we finalized interventions. Certain recommendations were shared across stakeholders and simple to integrate (e.g. costs → access to free services). Some recommendations varied, but complementary integration was possible (e.g. location versus recruitment → multiple recruitment in multiple community areas). Others were distinct across stakeholders and resulted in strategies to recognize participants' agency and inform their choices about breast cancer screening (e.g. differences in preferred information about screening → personalized information and evidence about all screening options).

Mentorship has been repeatedly shown to be a necessary component of successful professional development. However, effective mentorship can be elusive to define insofar as "you know it when you have it," but it is hard to match the objective qualities of mentorship with the subjective experience of effective and helpful mentoring. This article explores the Collaborative Family Healthcare Association's mentorship program from the perspective of one mentor and two mentees over the course of a yearlong formal relationship. During the year, both mentees had to navigate significant transitions, including changing jobs and having a baby; these experiences are relevant for many new career professionals. (PsycINFO Database Record

In 1985 South Africa adopted the Kairos Document, which is in essence a prophetic public theology, to use as a guide for their civil rights battle against Apartheid. This article establishes an argument for as well as an example of a prophetic public theology for the US to use as a guide as it addresses the never-ending battle against entrenched poverty and the growing concern(s) around a developing “plutonomy,” the fading middle class and the “new poor.”

The paradigm has shifted in care delivery models to effect improvements in both the quality and safety of patient care. Tele-Health integration is one example. By using mobile devices and the expertise of experienced clinicians in a remote location, bedside caregivers now can receive real-time assistance for patient management. The Tele-ICU is one example of an application of a technological model that accelerates clinical problem solving and decision-making, resulting in expediting critical care delivery and ultimately enhancing outcomes.

Mixed urinary incontinence (MUI) is a coexistence of stress (SUI) and urgency urinary incontinence (UUI). There is conflicting evidence on the effectiveness of midurethral slings (MUS) in this condition. The objective of this study is to evaluate the effectiveness of MUS in women with MUI by systematic review of the literature. Systematic literature search was carried (June 2010) using relevant search terms in Medline, EMBASE, CENTRAL and Google Scholar. Relevant randomised controlled trials (RCT) and prospective studies were selected and then analysed by two independent reviewers. Meta-analysis was performed with random effects model using STATA 8. There were six randomised trials and seven prospective studies with average to good quality included in this systematic review. There was heterogeneity in outcomes reported. The overall subjective cure from seven prospective nonrandomised studies that included patients with symptomatic ± urodynamically proven MUI was found to be 56.4% (95% confidence interval 45.7-69.6%) at 34.9 ± 22.9 months follow-up. The overall cure of urgency and UUI component was 30-85% at a follow-up of few months up to 5 years. Most of the studies described that this cure does not persist over the time. The cure rate of SUI following MUS varies from 85% to 97%. On meta-analysis of five RCTs which included women with MUI symptoms, the odds of overall subjective cure with TVT versus transobturator tapes are similar at 6-33 months follow-up (OR, 0.9; 95% CI, 0.63-1.27). This was true when a subgroup analysis was performed on women with MUI who were negative for DO on UDS (OR, 1.21; 95% CI, 0.7-2.08) There is evidence of persistent and good cure of stress component following MUS in women with MUI. The cure of the urge component is variable but less than stress component. Methodologically sound RCTs of retropubic and transobturator tapes with long-term follow-up are needed specifically for women with urodynamically proven and symptomatic mixed incontinence.

Objective: Assess if a classroom-based pharmacy education service for hospitalized headache patients newly prescribed a monoamine oxidase inhibitor (MAOI) results in, 1) higher self-perceived medication knowledge, or 2) lower perceived risk of using MAOIs.
 Subjects: Individuals admitted to an inpatient headache unit over a five month period
 Methods: Patient survey administered before and after the education service to any patient newly prescribed an MAOI.
 Results: Seventy-eight individuals completed the study. Paired-samples t-tests showed that for each of the four items related to self-perceived medication knowledge, the scores reflected higher knowledge after the MAOI class compared to before the class (p < 0.05). For three out of the four items related to perceived risk of using MAOIs, the scores reflected a lower level of perceived risk after the MAOI class compared to before the class (p < 0.05). One item did not significantly change: "The MAOI prescribed for me is just as good as other products available for treating headache." Conclusion: Our results demonstrate a pharmacist-conducted, classroom-based teaching method for newly prescribed MAOI patients can result in higher self-perceived medication knowledge and lower perceived risks.
 Type: Original Research

Acute generalized exanthematous pustulosis (AGEP) is a rare skin eruption most commonly caused by medications. It is characterized by fever and the acute eruption of non-follicular pustules overlying erythrodermic skin. Histopathology shows subcorneal pustules with a background of dermal edema and spongiosis, leukocytoclastic vasculitis, perivascular eosinophils, and focal necrosis of keratinocytes. Three cases of clindamycin induced AGEP have been reported in the literature. A case of AGEP due to clindamycin is reported in a patient with numerous other drug allergies and without history of psoriasis. Presentation and treatment of AGEP are reviewed.