Role of angiography in the diagnosis of pancreatic cancer

Endoscopic Retrograde Choledocho-Pancreatography, Ultrasonography and Computer Tomography can show dilated pancreatic duct in the patients with small resectable pancreatic carcinoma. However they can not predict the size of the tumor. Angiography is a complementary examination, being able to demonstrate the size of the tumor and predict its resectability.     

Differential diagnosis of lymphoid infiltrates in the lungs

Clinico-morphological and immuno-histological data on 15 cases of marked lymphocytic lung tissue infiltration are presented. The nature of B- and T-lymphocyte distribution, their proliferative activity as well as patterns of distribution of cells synthesizing light chains of immunoglobulins are described. In 12 cases, lymphocytic interstitial pneumonia was diagnosed; it featured distinct boundaries between zones of B- and T-lymphocytes of proliferating and resting cells. However, non-Hodgkin's lymphoma (MALT) detected in 3 cases lacked such a pattern. That might be interpreted as a marker of the particular pathology.     

Possibility of using tumor markers, pituitary gonadotropic hormones and prolactin in the diagnosis of breast cancer

The levels of gonadotropic hormones, prolactin, carcinoembryonic antigen (CEA) and ferritin were measured in 111 females (52--cancer, 32--benign tumors and 27--healthy controls in menopause). Radioimmunologic study showed a significant increase in prolactin, CEA and ferritin levels in patients with T1-2N0M0 breast tumors.     

Primary care utilization patterns before and after lung cancer diagnosis

The objective of this study was to evaluate change in primary care utilization rates after lung cancer diagnosis in the Veterans Health Administration. We used electronic medical record data (1997–2005) to identify male veterans ( n  = 323) with incident lung cancers. Primary care utilization rates were assessed in the 12-month period before and after cancer diagnosis. Statistical analysis included paired t -tests. Rates of primary care utilization decreased by 0.02 visits per person-month (VPPM) in the 12-month period after cancer diagnosis ( P  > 0.05). Utilization for acute conditions decreased by 20% ( P  < 0.01) in the 12-month period after diagnosis, from 0.32 VPPM before diagnosis to 0.12 VPPM after diagnosis. Utilization for chronic conditions remained stable after diagnosis (0.29 VPPM vs. 0.29 VPPM, P  > 0.05). Indications for primary care utilization after diagnosis were similar to indications for utilization prior to diagnosis. Common indications for utilization included hypertension and lower respiratory infections. We speculate that primary care utilization for acute conditions was lower after cancer diagnosis because several of the acute conditions (e.g. upper respiratory infection) treated prior to the cancer may have been harbingers of the cancer diagnosis. Additional research is required to illuminate how primary care can best be delivered during the initial phase of cancer treatment.     

Flexible fiberoptic bronchoscopy in metastatic cancer to the lungs

Seventy-eight patients with metastatic cancer to the lungs underwent flexible fiberoptic bronchoscopy for diagnosis. The patients were divided into two groups by presenting radiographic pattern as: (I) diffuse linear interstitial infiltrations (55 patients); and (II) localized or multiple nodular opacities (23 patients). The diagnosis of cancer was established by bronchoscopy in both groups of patients with approximately equal frequency. In Group I, bronchoscopic biopsy results were positive in 34 patients (62%), cytology results were positive in 30 patients (55%), and 42 patients (76%) had a positive biopsy and/or cytology result. In group II, biopsy results were positive in 14 patients (61%), cytology results were positive in 8 patients (35%), and 15 (65%) patients had a positive biopsy and/or cytology result. Patients whose chest radiograph showed atelectasis, suggesting the presence of endobronchial metastases, were excluded from the study. However, endobronchial examination unexpectedly revealed metastatic endobronchial carcinoma in 9 patients, 4 in Group I and 5 in Group II. Fiberoptic bronchoscopy is a relatively simple and direct technique for the histologic diagnosis of metastatic cancer to the lungs. Endobronchial metastases are common, even when not suspected by radiographic examination.     

Determinants of cancer patients' utilization of hospital care within two years after diagnosis

This study aimed to identify factors at diagnosis that are related to cancer patients' utilization of hospital care during the first 2 years after diagnosis, and thereby improve identification of patients with an increased need for close follow-up. Data from a prospective intervention study of psychosocial support and from a computerized patient administration system were used. A total of 393 newly diagnosed patients were included. Hierarchical regression analyses were performed to determine whether the addition of information regarding age, comorbidity, functional status, symptoms, and socioeconomic variables improved the prediction of utilization of specialist inpatient care beyond that afforded by cancer-related factors. In addition to cancer diagnosis and treatment, comorbidity, physical function, and pain determined use of inpatient care. Patients living in rural areas and those with a low income utilized hospital care more often. The results suggest that thorough assessment can identify patients at diagnosis with an increased need for follow-up, e.g. intensified home care services.