ABSTRACT
Nevus lipomatosus cutaneous superficialis (NLCS) is a rare cutaneous hamartoma characterized by mature adipocytes in the dermis. Here, we present a unique case of NLCS in a 57-year-old female that strikingly resembled an acrochordon, demonstrating features of the classical and solitary form of NLCS. This presentation of NLCS has not been widely reported and emphasizes that the diagnosis of NLCS should be considered when evaluating suspected acrochordons.
ABSTRACT
Estimates place low intake of fruits and vegetables, physical inactivity, and high BMI (overweight-obesity) as all in the top 12 causes of death. Food and dietary education are becoming a focus in how we approach disease prevention and management, and food prescription programs in particular are showing promise, especially in under-resourced, food-insecure communities. This paper describes a pilot food prescription program in a handful of uninsured patients enrolled in an interprofessional clinical and educational program of a medical school in South Florida. This case series of four patients struggling with food insecurity profiles the demographic and clinical characteristics of the participants and provides the results of standardized assessments of their dietary behaviors, physical activity levels, and attitudes toward food before and after the intervention. This four-month pilot food prescription program, Fresh Start Food Rx, involved a prospective case report of four patients seen on a mobile health center (MHC) for uninsured patients in South Miami, Florida. The MHC is part of an interprofessional health professions education, health care, and social service program of the Herbert Wertheim College of Medicine at Florida International University called the Neighborhood Health Education Learning Program (NeighborhoodHELP). A systematic review of South Miami MHC patient electronic medical records identified eligible participants for the program: patients with food insecurity and a BMI >30, with comorbid health conditions. Patients with greater BMI and more comorbidities were prioritized. Once enrolled, we provided biweekly packages of fresh fruits and vegetables along with monthly dietary education to the participants. Key measures included self-reported fruit and vegetable consumption, attitude toward healthy eating, and level of activity. Pre- and post-intervention focus groups assessed barriers the participants faced to eating healthy and pursuing physical activity, satisfaction with the program, feedback on strengths and weaknesses, and anticipated behavioral changes after completion of the program. Prior to the intervention, participants reported eating fruits on an average of 4.5 days out of the week. Post-survey answers increased to 5.0 days per week. Though the average amount of days per week that participants reported eating vegetables decreased slightly, the average number of vegetable servings that participants reported eating in a week increased. At termination of the program, most participants agreed that a diet rich in fruits and vegetables is good for you, that it is important to eat fruits and vegetables every day, and that a diet rich in fruits and vegetables can protect against cancer. This case study demonstrates that easier access to healthy foods, such as fresh produce delivery, and regular health education have the potential to promote healthier attitudes toward foods like fruits and vegetables. This change in attitude can then influence behavior, such as choosing to try new produce or increasing the amount and frequency of produce consumption. With the lessons learned from this small pilot program, the authors helped facilitate the expansion of a larger food prescription program in conjunction with a community partner hospital in the area. Findings from this experience might prove useful for others attempting to develop or expand a food prescription and health education program of their own.
ABSTRACT
BACKGROUND/CASE STUDIES: Despite decreased blood use, there are supply limitations. Therefore, it is important to determine the number of people potentially eligible to donate blood. This study updates an analysis from 2007 to estimate the pool of eligible blood donors in the United States. STUDY DESIGN/METHODS: We developed a revised epidemiologic model to account for changes in donor exclusion factors based on AABB standards. Donor exclusionary factors were identified and epidemiologic databases selected to enumerate the population prevalence of the donor exclusion factors. Prevalence data were adjusted for age, duration of exclusion, and comorbidities. The number of excluded individuals is calculated to estimate the current size of the eligible blood donor pool. The current study incorporates changes in demographic characteristics that have altered the pool of eligible blood donors. RESULTS/FINDINGS: The pool of eligible blood donors increased by approximately 93.9 million from 111 million persons in 2007 to 204.9 million persons in 2018, while the population of the United States increased by 34 million persons (from 293 million to 327 million). The number of donor exclusion factors increased from 31 to 38. Overall, the pool of eligible blood donors increased from 37.9% to 62.6% of the total population. The single largest change impacting the pool of eligible blood donors is the inclusion of individuals 65 years and older, increasing the eligible blood donor pool by 51 million of the new 93.9 million persons However, this increase in number of potential donors 65 years and older is offset by a corresponding increase in the prevalence of donor exclusion factor impact in individuals aged 65 years and above. CONCLUSION: A very large number of people are potentially eligible to donate blood. Therefore, blood supply limitations appear to be due to other factors. We suggest that these factors are differences in social commitments by changing demographic populations and the elimination of high-cost blood collection operations by blood suppliers.
