Disparities of food availability and affordability within convenience stores in Bexar County, Texas.

The American Diabetes Association (ADA) recommends healthful food choices; however, some geographic areas are limited in the types of foods they offer. Little is known about the role of convenience stores as viable channels to provide healthier foods in our "grab and go" society. The purposes of this study were to (1) identify foods offered within convenience stores located in two Bexar County, Texas, ZIP Codes and (2) compare the availability and cost of ADA-recommended foods including beverages, produce, grains, and oils/fats. Data were analyzed from 28 convenience store audits performed in two sociodemographically diverse ZIP Codes in Bexar County, Texas. Chi-squared tests were used to compare food availability, and t-tests were used to compare food cost in convenience stores between ZIP Codes. A significantly larger proportion of convenience stores in more affluent areas offered bananas (χ (2) = 4.17, P = 0.003), whole grain bread (χ (2) = 8.33, P = 0.004), and baked potato chips (χ (2) = 13.68, P < 0.001). On average, the price of diet cola (t = -2.12, P = 0.044) and certain produce items (e.g., bananas, oranges, tomatoes, broccoli, and cucumber) was significantly higher within convenience stores in more affluent areas. Convenience stores can play an important role to positively shape a community's food environment by stocking healthier foods at affordable prices.

Laparoscopic management of heterotopic pregnancy--a rare cause of acute abdomen in women.

Heterotopic pregnancy is a rare condition of coexisting intrauterine and extrauterine pregnancy and can present as an acute abdomen. The management can be challenging as the diagnosis is difficult to establish preoperatively. We report a case of a 31-year-old female presenting with acute abdominal pain and a mass in the right iliac fossa at 22 weeks of gestation. The patient was provisionally diagnosed as having an appendicular mass and was managed conservatively, however a diagnostic laparoscopy revealed the presence of an ectopic tubal pregnancy. This was successfully treated with laparoscopic right salpingectomy. A brief review of the management of heterotopic pregnancy is presented with an emphasis over laparoscopic management. The potential advantages and risks of laparoscopic approach in this situation are discussed. Laparoscopic management of these cases is possible, however, requires the availability of an experienced surgeon, trained staff, and laparoscopic equipment. Low-pressure pneumoperitoneum and use of direct vision ports for access is fundamental in achieving favorable maternal and fetal outcomes.