J Natl Med Assoc
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The African American (AA) community in Washington DC is at an elevated risk for hepatocellular carcinoma (HCC) that has a dismal prognosis. The recent rapid increase in the incidence and diagnosis of HCC and liver metastases (LM) in DC prompted us to evaluate the past six decades of this incidence and some of its underlying causes using a single institutional cohort in a hospital located in the center of the city. Electronic medical and pathology records of 454 liver cancer patients from 1959 to 2013 at Howard University Hospital (HUH) were reviewed. ⋯ Cases of liver metastases clinically diagnosed and confirmed by biopsies increased 96.4% from 1959 to 1968 to 2009-2013. This study confirms that HCC incidence has been increasing (initially driven by HCV, and NAFLD in the latter decades) more rapidly in DC than previously believed, highlighting the impact of case definitions especially regarding NAFLD in the context of changing diagnostic approaches including the revised ICD10. The rising burden, disproportionate population distribution, and low survival rate among AAs emphasize the importance of prevention and early detection as a public health imperative.
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To determine whether the homeless population experiences disparities in care and communication during inpatient hospitalizations in a safety-net hospital. ⋯ In an urban safety-net hospital, disparities in communications regarding medications between hospital staff and patients were found based on housing status.
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Over the past three decades, the term Mini-Medical School (MMS) has been used to describe programs offered by schools of medicine, which provide health education to the lay public and health career exposure to youth. The University of Maryland School of Medicine has operated an MMS program since 2001. The purpose of this study was to assess the sociodemographic characteristics of MMS participants and the impacts of this program on their health. ⋯ The health information provided by the MMS program is well-received and even anticipated by its participants. It has empowered them to care for themselves and for others by making them educated consumers and health advocates in their community. The MMS program should work with the School's community partners to make this resource more widely accessible, particularly to populations experiencing the most health disparities.
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Protests and the call to action in the aftermath of the deaths of Black citizens at the hands of police officers have reawakened the consciousness of American society on policing and the need for reforms. Racism in policing has a long history dating back to slave patrols following the Civil War. Criminal anti Black police behavior violates the police oath to "protect and defend" all individuals. ⋯ The forum panel concluded that reimagining policing especially at the community level will require multiple strategies that must include recruitment of a diverse group of police officers who can better represent their communities and society. As important, is better screening, testing and vetting of applicants to the police academy to route out those individuals who may demonstrate the potential for adverse behaviors antithetical to the police oath to protect and defend all people regardless of race and/or ethnicity.
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This review aims to provide primary medical and dental healthcare professionals with the current state of information on the oral manifestations of HIV infection in the era of antiretroviral therapy (ART) advancements. ⋯ Screening, diagnosing, and treating patients with HIV/Acquired immunodeficiency syndrome (AIDS) has improved drastically since the isolation and characterization of HIV. Oral manifestations have been acknowledged to correlate with treatment responses and disease progression. Healthcare providers should be familiar with HIV-related oral manifestations and comfortable in managing and referring patients with HIV/AIDS, they are also key stakeholders in facilitating the elimination of the stigma associated with the infection.