From the Editor's Desk

This second issue of the Ochsner Journal has a diverse rather than topical orientation. The original articles in this issue have been chosen for their practical importance for the clinician. First, Dr. Troy Scroggins describes a number of barriers to cancer screening among African Americans including a high frequency of widely held myths and misconceptions. The positive message to come from his very interesting field survey is that most African Americans are legitimately concerned about their risk of cancer and would be willing to participate in cancer screening programs. This should make it much more likely that a culturally sensitive approach to education would have positive impact for the health status within this community of patients. Dr. George Fuhrman describes the management of melanoma from the standpoint of how the finding of a negative sentinel node should change the traditional surgical approach to regional lymphadenectomy. The advantages of sentinel node mapping (i.e., reduction of patient morbidity), the limitations with this technique, and the evolving experience at Ochsner Clinic are addressed in Dr. Fuhrman's article. Dr. Mandeep Mehra, describes how an intensive approach to better patient education and vigorous outpatient treatment can substantially reduce the number of hospitalizations for congestive heart failure. After reading Dr. Mehra's article, I think you will agree that this strategy not only has an impact on how our health care dollars are spent on these patients, but just makes good medical sense. Subsequently, Dr. Charles Geno describes the evolving experience with obstetrical delivery as a component piece of Family Practice Training. Importantly, this article also addresses guidelines for newborn deliveries that are more appropriately placed in the hands of the obstetrical physician and neonatologist.

This second issue also christens two other regular features of the journal, a clinical algorithm, dealing with the management of peptic ulcer disease, and a basic science review, discussing the relationship between herpesvirus 8 and Kaposi's sarcoma. The continuous use of acid suppressive therapy has been variably successful in prevention of recurrent ulcer disease and makes little sense from a medical and economic perspective now that an etiologic agent (Helicobacter pylori) has been found to be the cause of much of the peptic ulcer disease in the world today. The message with Dr. Om Prakash's review of Kaposi's sarcoma is clear: new and unique viral agents have a triggering effect on endothelial cell proliferation, in ways which are now being defined at a molecular level. The result is that a formerly uncommon malignancy has become the leading neoplasm among HIV-infected patients. Finally, reader response to Scanning the Literature in the first issue of the Journal has been very positive, and we continue to concentrate in this second issue on articles published elsewhere that focus on common clinical entities facing many physicians.

We hope that you enjoy reading the Ochsner Journal. Let us know by filling out the included postage-paid reply card and dropping it in a post office box near you.