Colorectal cancer screening completion by patients due or overdue for screening after reminders: a retrospective study.

BACKGROUND: Patient and clinician reminders were implemented as part of an adherence improvement project at University of Florida (UF) Internal Medicine Clinics. We sought to assess colorectal cancer (CRC) screening completion rates among patients not up-to-date with screening following distribution of reminders and to identify characteristics correlated with screening outcomes. METHODS: Retrospective chart review was performed for patients not up-to-date with CRC screening for whom at least one reminder (patient and/or clinician) was issued in June 2018. The primary endpoint, the completion of a CRC screening test, is characterized as the ratio of completed screening tests to the number of patients not up-to-date with screening. All analyses were performed using R 4.0 software. RESULTS: Of the 926 patients included, 403 (44%; 95% CI, 0.40-0.47) completed a CRC screening test within 24 months following a reminder. Family history of CRC (relative risk (RR) 1.33; P = 0.007), flu immunization within two years of the reminder (RR 1.23; P = 0.019), and receiving a patient reminder either alone (RR 1.62; P < 0.001) or in combination with a clinician reminder (RR 1.55; P = 0.006) were positively associated with CRC screening completion. Reporting being divorced, separated, or widowed was negatively associated with screening completion (RR 0.70; P = 0.004). CONCLUSION: Reminders, in particular patient reminders, seem to be an effective method to enhance screening among patients not up-to-date with CRC screening. This study suggests that reminder efforts should be focused at the level of the patients and provides insight on target populations for practical interventions to further increase CRC screening adherence.

Educational Case: Smooth Muscle Tumors of the Uterus.

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040. 1.

Educational Case: Opportunistic Infections of the Central Nervous System.

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.1.

Evaluating differences in tuberculosis and nontuberculous mycobacterial lung disease in Florida.

BACKGROUND: Currently, very little data exists that compare the features of pulmonary nontuberculous mycobacteria (NTM) and Mycobacterium tuberculosis (TB). Both have similar symptomology and analogous preliminary laboratory results, as both present with positive acid-fast bacilli stains. The objective of this study was to provide data that would help guide clinicians in their decision making regarding isolation precautions for patients, with a preliminary positive result for mycobacteria, prior to species identification. METHODS: We conducted queries for patients who had positive respiratory cultures for mycobacteria via our electronic medical record system, between January 1, 2011, and December 31, 2017. Additionally, we collected demographic and medical history, clinical presentation, and radiographic findings. The 2-sample unpaired Student t test, the Χ2 test, and logistic regression were used to compare each group. RESULTS: Through logistic regression, 8 variables were significantly associated with patients who grew either TB or NTM. History of incarceration, born outside of the United States, cavitation, and lymphadenopathy were associated with TB; tobacco smoke exposure, pre-existing lung disease, immunosuppression, and bronchiectasis were associated with NTM. Incidence of HIV and hemoptysis was not significantly different between the 2 groups. CONCLUSIONS: Through the use of our study findings, improper use of airborne isolation precautions may be reduced or avoided.

Sample-to-result molecular infectious disease assays: clinical implications, limitations and potential.

Molecular infectious disease diagnostic tests have undergone major advances in the past decade and will continue to rapidly evolve. Assays have become extraordinarily simple to perform, eliminating the need for pre-analytic sample preparation and post-amplification analysis. This allows these tests to be performed in settings without sophisticated expertise in molecular biology, including locations with limited resources. Additionally, the sensitivity and specificity of these assays is superb and many offer extremely fast turn-around times. These tests have major impacts on patient care, but also have some limitations.