The East Harlem Partnership for Cancer Awareness (EHPCA) was formed in 1999 to reduce disparities in cancer screening and prevention among medically underserved minorities residing in a large urban community (East Harlem, New York City) by increasing awareness of cancer risk, prevention, and treatment, and promoting greater participation in breast, cervical, colorectal, and prostate cancer screening and early detection. The Partnership augments a 20-year collaboration between an academic medical center, a public hospital, and 2 community health centers. Needs assessments were conducted to inform program development. Cancer education, outreach, and screening programs were developed based on the PRECEED-PROCEED model for health education and health promotion programming. Needs assessments revealed that although the majority of the population (86%) was insured and had a source of primary care, cancer screening guidelines for breast, cervical, prostate, and colorectal cancers were not being followed. Outreach strategies, targeted curricula, educational sessions, and screening programs have been developed and implemented to improve knowledge levels and increase screening participation. The EHPCA is a model of a successful partnership among the public and private sectors to reduce disparities in cancer screening and prevention in a diverse, medically underserved, urban minority community. Future efforts to reduce cancer screening disparities in this population will include patient navigation and improved access to standard-of-care screening such as colonoscopy. Cancer 2006. (c) 2006 American Cancer Society.
Pedunculated melanoma is a rare type of melanoma. Conventional staging methods for melanoma may not be reliable in this type of tumor. Complete workup, possibly including sentinel lymph node dissection, should be performed in all patients with pedunculated melanomas.
We describe 3 patients with thrombotic thrombocytopenic purpura (TTP) treated with vincristine. In 2 of them, multimodality treatment with plasmapheresis, acetylsalicylic acid, dipyridamole, corticosteroids, and plasma infusions did not achieve lasting remission, subsequent to which the administration of vincristine was followed by prompt and durable remission. In the third patient, 1 mg of intravenous vincristine as initial therapy in conjunction with multimodality treatment resulted in the prompt resolution of the disease. Our experience suggests that vincristine is effective in the treatment of TTP and can be used as initial treatment in combination with other modalities.
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