Primary peritoneal serous carcinoma: a primer for radiologists.

Primary peritoneal serous carcinoma (PPSC) is a rare primary peritoneal tumor characterized by a unique range of clinical features and imaging findings. Though it shares many clinical, histologic, and imaging features with serous ovarian carcinoma, it remains a distinct clinical entity. Although less common than its primary ovarian counterpart, PPSC is characterized by a prognosis that is often equally poor with presentations common in late stages of disease. Key imaging modalities used in the evaluation of PPSC include ultrasound, CT, MRI, and PET/CT. For radiologists, an understanding of the pertinent imaging findings, pathologic correlations, and clinical features of PPSC is essential for arriving at the correct diagnosis and guiding the subsequent appropriate management of this complex malignancy.

Ultrasound First for Removal of Nonpalpable Contraceptive Implants.

The Sound Judgment Series consists of invited articles highlighting the clinical value of using ultrasound first in specific clinical diagnoses where ultrasound has shown comparative or superior value. The series is meant to serve as an educational tool for medical and sonography students and clinical practitioners and may help integrate ultrasound into clinical practice.

Impact of an education-centered medical home on quality at a student-volunteer free clinic.

BACKGROUND: The continuity provided by longitudinal clerkships has documented benefits to medical student education. Yet, little quantitative data exist on the association between longitudinal clerkships and patient outcomes. OBJECTIVE: This study compares screening metrics of a longitudinal clerkship called the education-centered medical home (ECMH) with the standard clinical model at a student-volunteer free clinic (SVFC). In the ECMH model, the same attending physician staffs one half-day of clinic with same group of students weekly for 4 years. Standard clinical models are staffed with students and physicians who come to the SVFC based on availability. DESIGN: ECMH students aimed to increase human immunodeficiency virus (HIV) screening rates in their patient panel as part of a quality improvement project. Students prepared individualized care plans prior to patient visits that included whether screening had been performed. They were also reminded to confirm completion of testing. Percentages of patients screened for HIV before and after establishment of the ECMH were compared with four standard clinical models. Screening rates for breast, colon, and cervical cancer, as well as hepatitis C, served as secondary endpoints. RESULTS: While screening rates were initially similar between models (43.2% and 34.8% for the ECMH and standard clinical panels, respectively, p = 0.32), HIV screening rates increased from 43.2% to 95.0% in the ECMH compared with a significantly smaller increase from 35.0% to 50.0% in the standard clinical panel (p < 0.0001). Additionally, the ECMH resulted in statistically significantly increased screening rates for cervical cancer (p < 0.001) and hepatitis C (p < 0.0001). CONCLUSIONS: This study demonstrates an association between a longitudinal ECMH clerkship and improved quality metrics at an SVFC. Even measures not targeted for intervention, such as colorectal cancer and hepatitis C, showed significant improvement in screening rates when compared with the standard clinical model.