Inflammation and Colorectal Cancer.

Colorectal cancer (CRC) is the fourth most common cancer in both men and women in the United States, resulting in over 55,000 deaths annually. Environmental and genetic factors influence the development of CRC, and inflammation is a critical hallmark of cancer that may arise from a variety of factors. PURPOSE OF REVIEW: While patients with inflammatory bowel disease (IBD) have a higher risk of developing CRC, sporadic CRCs may engender or be potentiated by inflammation as well. In this review, we focus on recent advances in basic and translational research utilizing murine models to understand the contribution of inflammatory signaling pathways to CRC. RECENT FINDINGS: We discuss advances in the utility of three-dimensional enteroid/colonoid/tumoroid cultures to understand immune-epithelial interactions in CRC, as well as the potential for utilizing patient-derived tumoroids for personalized therapies. SUMMARY: This review underscores the importance of understanding the complex molecular mechanisms underlying inflammation in sporadic CRC and highlights up-and-coming or new avenues for CRC biomarkers or therapies.

The ABCs of physician billing compliance plans.

As it evolves, an organization's compliance plan will become an effective risk-management tool. As the price for noncompliance becomes ever higher, the development and implementation of a corporate compliance plan makes both common and fiscal sense. A compliance plan should not be a program that is rolled out and then allowed to sit on the shelf and gather dust. The only thing worse than not having a compliance plan is having one and not following it.

Pediatric emergency medicine fellow clinical work requirements.

A wide range of clinical requirements exists among PEM fellowship programs. Programs are equally split concerning the question of whether fellows should work with supervision or independently in the first year; a significant number of fellowship programs require continued supervision of fellows in subsequent years. Orientation for first year fellows and requirements for completion of PALS, advanced pediatric life support (APLS), ACLS, or ATLS courses prior to their first independent shift varied greatly. In particular, a minority of programs required ATLS completion even though a majority of overall fellowship programs operate in a hospital designated as a Level 1 Trauma Center. Programs in which first-year fellows worked independently had fewer attendings and were less likely to provide 24-hour coverage. Fellows appear to work a similar or less demanding schedule than PEM attendings in most fellowship programs, and most fellowship directors feel that their fellows should continue with their current schedule.

Determinants of serum DDT and DDE concentrations.

CONCLUSIONS: 1) Measurements of serum DDT concentration are capable of relfecting changes in oral DDT intake accurately and promptly. 2) Serum DDE level is only slightly increased by a 300-600 fold increase in DDT intake over a period of 5 months. It is therefore an essentially worthless measure of recent change in oral DDT intake. Stable individual differences in serum DDE levels, seemingly much wider than differences in dietary patterns (i.e. DDE intake), suggest the importance of individual metabolic factors in determining this level. 3) A high degree of correlation between serum DDT and DDE in day to day samples extracted once by hexane, probably reflects changes in extractability influencing the two measurements similarly.