Abstract:
OBJECTIVES:Adherence to National Comprehensive Cancer Network (NCCN) guidelines for ovarian cancer treatment improves patient outcomes. The aim of this study was to assess disparities associated with ovarian cancer treatment in the state of Kentucky and central Appalachia. METHODS:Data on patients diagnosed as having ovarian cancer from 2007 through 2011 were extracted from administrative claims-linked Kentucky Cancer Registry data. NCCN compliance was defined by stage, grade, surgical procedure, and chemotherapy. Selection criteria were reviewed carefully to ensure data quality and accuracy. Descriptive analysis, logistic regression, and Cox regression analyses were performed to examine factors associated with guidelines compliance and survival. RESULTS:Most women were aged 65 years or older (62.5%) and had high-grade (65.9%) and advanced-stage (61.0%) ovarian cancer. Two-thirds of cases (65.9%) received NCCN-recommended treatment for ovarian cancer. The hazard ratio of death for women who did not receive NCCN-compliant care was 62% higher compared with the women who did receive NCCN-compliant treatment. Results from the logistic regression showed that NCCN-compliant treatment was more likely for women aged 65 to 74 years compared with women aged 20 to 49 years, late-stage compared with early-stage cancers, receipt of care at tertiary care hospitals, and privately insured compared with Medicaid or Medicare. CONCLUSIONS:When the treatment of ovarian cancer did not follow NCCN recommendations, patients had a significantly higher risk of death. Women were less likely to receive NCCN-compliant care if they were younger (20-49 years), had early-stage disease, did not have private insurance, or had care provided at a nontertiary care hospital.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Ore RM,Chen Q,DeSimone CP,Miller RW,Baldwin LA,van Nagell JR Jr,Huang B,Tucker TC,Johnson MS,Fredericks TI,Ueland FRdoi
10.14423/SMJ.0000000000000821subject
Has Abstractpub_date
2018-06-01 00:00:00pages
333-341issue
6eissn
0038-4348issn
1541-8243pii
SMJ50549journal_volume
111pub_type
杂志文章abstract::In a patient with left ventricular failure complicated by shock and impairment of right ventricular function caused by an infarct, right atrial pacing improved cardiac output. We believe right atrial pacing offers an alternative to plasma volume expansion, afterload reducing agents, and inotropic drugs. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198103000-00030
更新日期:1981-03-01 00:00:00
abstract::The clinical, pathologic, and roentgenographic features of macrodactylia fibrolipomatosis described are based on 40 cases from the literature and five cases seen by the authors. This condition previously has been described as macrodactyly, megalodactyly, macrodystrophia lipomatosa, dactylomegaly, and local gigantism. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197612000-00015
更新日期:1976-12-01 00:00:00
abstract::An autopsy of a probable case of MCLS is described. After 10,000 cases have been recorded in Japan, the disease is being recognized in the United States. There may be an overlap with infantile periarteritis nodosa. Pathologic studies of fatal cases of MCLS diagnosed during life have not been reported in this country. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197809000-00040
更新日期:1978-09-01 00:00:00
abstract::We have described a 47-year-old white woman who had spontaneous E coli K1 meningitis after acquiring an E coli K1 urinary tract infection with associated sepsis. The patient's symptoms consisted only of severe headache, fever, and malaise. She had no meningeal or focal neurologic signs, and the CSF did not contain whi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198309000-00044
更新日期:1983-09-01 00:00:00
abstract::Axillary and palmar hyperhidrosis are featured prominently in the literature, but no previous studies have detailed a treatment regimen for specific excessive localized sweating of the face and scalp. In this report, a patient was treated for this condition with a combination of clonidine hydrochloride (0.3 mg to 0.4 ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Unremitting diarrhea is a common problem in patients with AIDS. We have reported the case of such a patient who was treated with the somatostatin analogue octreotide for chronic diarrhea and who had acute pancreatitis as a consequence of this therapy. We postulate that the possible mechanism for the pathogenesis of th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199111000-00035
更新日期:1991-11-01 00:00:00
abstract::Infection with Mycobacterium kansasii in patients with acquired immunodeficiency syndrome usually involves the lung or disseminated infection. We report a case of infection with M kansasii confined to the adrenal gland and possibly to an adjacent vertebral body that presented as a fever of undetermined origin. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199810000-00019
更新日期:1998-10-01 00:00:00
abstract::Two siblings had frequent seizures from the second and third day of life until one week and seven months, respectively. The mother, grandmothers, and three other family members were similarly affected. Known causes of neonatal seizures were excluded. The condition is inherited as an autosomal dominant trait. Its etiol...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198205000-00038
更新日期:1982-05-01 00:00:00
abstract:OBJECTIVE:This study compares the primary health care quality of community health centers (CHCs) and health maintenance organizations (HMOs) in South Carolina to elucidate the quality of CHC performance relative to mainstream settings such as the HMO. METHODS:Mail surveys were used to obtain data from 350 randomly sel...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000066811.53167.2E
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:The objective of the study was to determine whether treatment with protease inhibitors is associated with unprotected sexual behavior. METHODS:A total of 592 HIV-infected persons recruited from statewide public clinics in nonurban Alabama communities completed an assessment that, among other variables, elic...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2002-04-01 00:00:00
abstract::Superior mesenteric artery (SMA) syndrome is an atypical cause of high intestinal obstruction, most frequently occurring in patients who have had rapid weight loss. Identification of this syndrome can be a diagnostic dilemma and is frequently made by exclusion. The most characteristic symptoms are postprandial epigast...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract::This study was done to ascertain whether there was an increased incidence of acute rheumatic fever (ARF) in west Alabama, similar to that reported elsewhere within the United States. Hospital records for the previous 10 years were reviewed and 5-year intervals were compared (1980 through 1984 vs 1985 through 1989). A ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199203000-00007
更新日期:1992-03-01 00:00:00
abstract::Transient synovitis of the hip is an acute and self-limited disease commonly seen in children. It is the most common cause of acute hip pain in children ages 3 to 10. It is not considered a disease of adults. It usually only affects one hip. The child may complain of pain that is much worse with walking and may actual...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000199746.29009.4c
更新日期:2006-02-01 00:00:00
abstract::Even though epidural analgesia is effective and has advantages over conventional postoperative analgesia, it is also labor intensive, requiring 24-hour supervision by an anesthesiologist. In an effort to decrease the manpower requirements, some hospitals allow the nursing staff to administer epidural narcotics to adul...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199204000-00012
更新日期:1992-04-01 00:00:00
abstract::The management of inflammatory carcinoma of the breast remains a therapeutic dilemma because of two basic conceptual problems: local control and systemic micrometastatic disease. Appropriate management requires a multidisciplinary approach involving radiation therapy, surgery, and medical oncology. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198102000-00020
更新日期:1981-02-01 00:00:00
abstract::We retrospectively reviewed 20 surgically confirmed tubo-ovarian abscesses in postmenopausal women for the period 1973 to 1989. Pain and bleeding were the two most common presenting symptoms. Nine of the 20 patients (45%) had recently had endometrial instrumentation. Fever and the presence of a pelvic mass and elevate...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199207000-00006
更新日期:1992-07-01 00:00:00
abstract::The oropharyngeal function study is a videotaped radiographic examination of the oropharynx and cervical esophagus used in patients who are at major risk for aspiration because of swallowing difficulty. Preceding the radiographic evaluation, the patient is assessed clinically by a swallowing therapist who attends the ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199002000-00013
更新日期:1990-02-01 00:00:00
abstract::To our knowledge, this is the first known case of a patient with leptospirosis and very elevated CSF, which caused hydrocephalus. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181a0ae80
更新日期:2009-05-01 00:00:00
abstract::Brown recluse spider bites may result in extensive soft tissue injury, causing months of disability. We have described a patient who had a series of extensive surgical debridements after envenomation. Despite skin grafting, persistent cutaneous lesions and extensive satellitosis progressed to involve the entire lower ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199002000-00029
更新日期:1990-02-01 00:00:00
abstract::The sonographic and clinical findings in four patients with silicone-augmented breasts are presented. The ultrasonographic differences between breasts with silicone injections and breasts with silicone prosthesis are emphasized. Breast sonography may play a role in evaluation of silicone-augmented breasts. Awareness o...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198104000-00021
更新日期:1981-04-01 00:00:00
abstract::Treatment of major abdominal vascular injuries is a challenge. Since 1973, 93 patients have been treated at our institution for 147 abdominal vascular injuries. The majority of these injuries (67%) resulted from penetrating trauma in young men between 21 and 30 years of age. Upon admission 72% of the patients were in ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198510000-00003
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVES:Insurance status has the potential to play a significant role in an individual's health care by affecting the time of diagnosis and the treatment options used. Our study reviewed insurance status as a determinant of the time of a breast cancer diagnosis as well as the surgical treatment options offered. MET...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000281
更新日期:2015-05-01 00:00:00
abstract::Diabetic ketoacidosis can be effectively and economically treated by using low-dose intravenous insulin and 2 to 3 liters of isotonic saline at 500 ml/hr to replace extracellular fluids, followed by 2 to 4 L of 5% glucose in 0.45% saline with potassium chloride and/or potassium phosphate to replace intracellular fluid...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198707000-00017
更新日期:1987-07-01 00:00:00
abstract::Two patients with polycystic kidney disease and renal failure developed profound hypotension within 30 minutes after starting hemodialysis. After ruling out all recognized causes of hypotension during early dialysis, we found that their vena cavas were obstructed by compression of the vessels against the spinal column...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197911000-00013
更新日期:1979-11-01 00:00:00
abstract::HBsAg and anti-HBs positivity was determined in hospital laboratory workers and nonlaboratory hospital workers (controls) matched for race and sex and adjusted for age. The combined prevalence of antigen-antibody positivity among white female technicians was 12% versus 0 of controls (P less than 0.005). The highest pr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197709000-00020
更新日期:1977-09-01 00:00:00
abstract::Rapid, extreme expansion of the extracellular fluid with solutions devoid of acid or alkali theoretically can produce a metabolic acidosis, due to buffer dilution. This phenomenon has previously been demonstrated only in experimental animal studies. We have reported what we believe to be the first documented case of h...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199003000-00029
更新日期:1990-03-01 00:00:00
abstract::Like the introduction of bare metal stents (BMS), that of drug-eluting stents (DES) represented a quantum leap in the interventional cardiology community's ongoing efforts to conquer restenosis. However, recent concerns over late thrombosis (LT) have tempered the initial enthusiasm. Nonetheless, when compared with BMS...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000286752.67205.e0
更新日期:2008-02-01 00:00:00
abstract::To determine sensitivity and specificity of magnetic resonance imaging (MRI) and ultrasonography (US) in the detection of breast implant rupture, and also to determine the relative merits of clinical examination and mammography, we studied 81 patients (160 implants). All patients had implants removed, thus allowing co...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199604000-00009
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to assess the cardiovascular health status of baby boomers with diabetes mellitus (DM) in comparison to the same-age population with DM 10 years previously. METHODS:The study was conducted in baby boomers with DM using data from the National Health and Nutrition Examination S...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000473
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:To explore breast cancer beliefs among a cohort of low-income, urban, English-speaking women in Miami, Florida, who had undergone screening mammography. METHODS:Four focus groups of 34 women were conducted. Discussions were transcribed verbatim and transcripts were analyzed separately by two investigators u...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0000000000000022
更新日期:2013-12-01 00:00:00