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. METHODS:The American College of Surgeons' National Cancer Database benchmark reports were used to examine first-course surgery stratified by the stage of breast cancer diagnosed between 2000 and 2010. The data were stratified according to insurance status with a focus on insured patients versus underinsured patients. The relations among insurance status, breast cancer stage at the time of presentation, and initial treatment offered were then evaluated. RESULTS:There was a statistically significant relation between breast cancer stage at the time of diagnosis and insurance status. There also was a relation between insurance status and the treatment offered. Adequately insured patients presented at an earlier stage than did underinsured patients. In addition, in patients who present with early-stage disease, insured patients had a higher rate of breast-conserving surgery than did underinsured patients, 62.4% and 55.5%, respectively. This trend continued in late-stage breast cancer, in which mastectomy was the predominant treatment option overall. Despite this, insured patients underwent breast-conserving therapy more frequently than did underinsured patients, 24.2% and 21.2%, respectively. CONCLUSIONS:The discrepancy of the stage of diagnosis between insured patients and underinsured patients can be attributed to a host of factors, among which are access to regular office visits and screening tests for breast cancer. In addition, the surgical treatment options used may depend on the cost of treatment and accessibility to and compliance with follow-up care.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Lukavsky R,Sariego Jdoi
10.14423/SMJ.0000000000000281subject
Has Abstractpub_date
2015-05-01 00:00:00pages
258-61issue
5eissn
0038-4348issn
1541-8243pii
SMJ14301journal_volume
108pub_type
杂志文章abstract::A case of unilateral primary adrenal hyperplasia, without concomitant hypokalemia, is presented. After surgical removal of the gland, a complete remission occurred. This rare condition may, in fact, be more frequent than thought as it can coexist with normokalemia. We postulate that it is probably a new phase of the t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199406000-00017
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:Screening mammography, particularly for women in their 40s, has become a confusing issue for many physicians. Recent scientific and political controversies regarding screening guidelines have added to this confusion. METHODS:Many randomized clinical trials have shown the benefits of mammographic screening f...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract::Nitrogen, derived from breakdown of dietary amino acids as ammonia, is normally converted to urea and excreted. Impairment in the conversion process (called the urea cycle) can occur, either as a consequence of primary genetic defects or through secondary suppression of enzyme activity. Either process results in hyper...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199307000-00004
更新日期:1993-07-01 00:00:00
abstract::Pseudoepitheliomatous hyperplasia (PEH) arises in areas of chronic inflammation and can be mistaken for squamous cell carcinoma, leading to unnecessary removal of more tissue. We present a study of 21 patients having delayed reconstruction of defects left by Mohs micrographic surgery (MMS) to remove facial skin cancer...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199504000-00014
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:No standard therapeutic option exists for men with prostate cancer who have failed local therapy, have no gross metastatic disease, and whose only manifestation of disease is a rising prostate-specific antigen (PSA) level. Soy products are able to affect PSA kinetics in some men with prostate cancer, and this...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3182335151
更新日期:2011-11-01 00:00:00
abstract::Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis of the liver. The organisms most commonly involved in this infection are gram-negative bacteria like Escherichia coli and Klebsiella pneumoniae, and gram-positive bacteria like Streptococcus pneumoniae and Staphylococcus aureus...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2002-10-01 00:00:00
abstract::Ours is apparently the first reported pediatric case of Stomatococcus mucilaginosus bacteremia. It is the second reported case of S mucilaginosus catheter-associated infection, but the first case successfully treated without removing the central venous catheter. This unusual organism should be added to the list of opp...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199103000-00029
更新日期:1991-03-01 00:00:00
abstract::Tobacco use is associated with numerous illnesses and contributes to as many as 400,000 deaths in the United States each year. Most tobacco use in the United States is in the form of cigarette smoking, but smokeless tobacco use is particularly high in certain areas and within certain subpopulations. Among US adults, s...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:We sought to determine the frequency of anserine bursitis (AB) in Koreans with osteoarthritis (OA) of the knee and its relationship to age, sex, and radiographic severity of OA, and to evaluate its response to various forms of therapy. METHODS:In a retrospective study, we reviewed the charts of patients wit...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract::An elderly man with previous tuberculosis exsanguinated from esophageal rupture of an atherosclerotic thoracic aneurysm. Because the patient refused angiography, the source of bleeding was discovered only at autopsy. Selected clinical and pathologic aspects of the case are discussed in relation to the different causes...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00042
更新日期:1979-07-01 00:00:00
abstract::We describe two patients who had tuberculomas that were initially misdiagnosed as neurosarcoidosis, leading to prolonged steroid therapy before initiation of antituberculous medications. Neither patient was infected with the human immunodeficiency virus, and one of the patients had a negative tuberculosis skin test. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000048150.02504.99
更新日期:2003-05-01 00:00:00
abstract::Elevation in fasting serum gastrin levels was found in three patients being evaluated for persistent upper abdominal pain without radiographic evidence of peptic ulcer disease. Fiberoptic endoscopy of the upper gastrointestinal tract in each patient revealed characteristic changes of chronic atrophic gastritis. Gastri...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197612000-00010
更新日期:1976-12-01 00:00:00
abstract::Geographic variations in adverse health outcomes have long been recognized in the United States, with specific focus on the southeastern region of the country. Cerebrovascular disease mortality rates have identified the Southeast as the "stroke belt" for decades, though rates are also high for other hypertension-relat...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199702000-00005
更新日期:1997-02-01 00:00:00
abstract::Clotrimazole is a new antifungal agent which is effective topically in dermatophytosis, cutaneous candidiasis, and tinea vesicolor. The authors performed a controlled double-blind clinical trial comparing topical clotrimazole with its vehicle in the treatment of 66 patients with dermatophytic infections of the skin of...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/00007611-197701000-00021
更新日期:1977-01-01 00:00:00
abstract::In this series, thorough evaluation of 250 mediastinal lesions by various diagnostic methods showed that contrast enhanced CT scans of the mediastinum were superior to other modalities in differentiation and precise localization of the various types of lesions. Such superior evaluation may have a profound effect on th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198504000-00009
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:This study aimed to identify differences in perceptions between healthcare and non-healthcare personnel when it comes to wearing scrubs in non-healthcare settings. METHODS:An anonymous survey with 11 closed-ended questions sent via e-mail to healthcare students and employees at The University of Texas Health...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000861
更新日期:2018-09-01 00:00:00
abstract::Seven patients with diabetes of ten to 24 years' duration and renal insufficiency were treated with fluphenazine and amitriptyline in an attempt to control severe pain in the extremities. Six patients had relief of pain within five days of initiation of therapy. One patient had no pain relief despite mood alteration. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::Considerable controversy exists with regard to therapeutic efficacy of plasmapheresis in the immune-mediated demyelinating disorders of the peripheral and central nervous system: acute inflammatory polyneuropathy (Guillain-Barré syndrome), chronic inflammatory demyelinating polyneuropathy, and multiple sclerosis. In a...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198608000-00018
更新日期:1986-08-01 00:00:00
abstract::For various reasons, patients seek care at different hospitals within a region, resulting in fragmented medical records at the point of care. In the emergency department, this is a particularly important issue because the emergency department provides open access to all patients and requires rapid high-stakes decision...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e318296ed67
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:Code status specifies the action that healthcare providers should take in the event of cardiac arrest. Studies have shown, however, that patients with do-not-resuscitate/do-not-intubate (DNR/DNI) orders have worse outcomes and do not consistently receive the standard of care. Several studies have demonstrate...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001112
更新日期:2020-07-01 00:00:00
abstract::A patient who presented with recurrent syncopal episodes was discovered to have a right-sided heart mass, which was revealed as an embolus in transit resulting in a lethal pulmonary embolic event. The initial focus of etiology on tumor rather than thrombus was misleading. A higher index of suspicion of thrombus in rig...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000056644.09367.F3
更新日期:2003-11-01 00:00:00
abstract::The association between acute coronary events and acute allergic reactions has been recognized for several years. The first reported case occurred in 1950, during an allergic reaction to penicillin. In 1991, Kounis and Zavras described the syndrome of allergic angina and allergic myocardial infarction, currently known...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181f8c56f
更新日期:2010-11-01 00:00:00
abstract::A 25-year-old white woman was hospitalized with a postpartum psychosis presenting as an affective disorder with the delusion of Capgras. She was treated with electroconvulsive therapy with resolution of her affective and delusional states. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197708000-00012
更新日期:1977-08-01 00:00:00
abstract::Pregnancy is a state of many hormonal changes that can make interpretation of thyroid function tests difficult. Measuring trimester-specific reference values of thyrotropin and free thyroxine is recommended. Because overt maternal hypothyroidism negatively affects the fetus, timely recognition and treatment are import...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3182a66610
更新日期:2013-09-01 00:00:00
abstract::We report two cases of lymphangiomyomatosis with pleural and peritoneal chylous effusions, one without pulmonary involvement. The first patient died after seven years. The second received external irradiation to control the chylous ascites and remains alive 12 years later. The disease appears to be estrogen-dependent,...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198408000-00024
更新日期:1984-08-01 00:00:00
abstract:BACKGROUND:Increasing numbers of the adult population are using alternative or complementary health resources in the treatment of chronic medical conditions. Systemic hypertension affects more than 50 million adults and is one of the most common risk factors for cardiovascular morbidity and mortality. This study evalua...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007611-200111000-00015
更新日期:2001-11-01 00:00:00
abstract::Maffucci's syndrome in a 17-year-old girl is reported. Since the entity was first described in 1881 by Maffucci, 105 additional cases have been recorded. Several series have reported a small but significant percentage of cases (up to 18%) with malignant change. Our case, although not particularly unique in comparison ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197804000-00033
更新日期:1978-04-01 00:00:00
abstract::Hypersplenism is a known complication of portal hypertension secondary to cirrhosis of the liver. Although thrombocytopenia secondary to hypersplenism does not cause clinically significant hemostatic defect, it may need to be addressed in selective circumstances, such as preoperative preparation for a surgery. This re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000157558.62378.0B
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Nontubercular mycobacteria (NTM) are increasingly recognized to cause lung disease in immunocompetent patients. We studied the occurrence of pulmonary infection due to NTM in immunocompetent men. METHODS:We retrospectively analyzed all sputum mycobacterial cultures at our institution over a 5-year period. C...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-07-01 00:00:00
abstract::As our population ages, the incidence and prevalence of Alzheimer disease (AD) will increase dramatically. A number of therapies have been investigated for the treatment and prevention of AD. Clinicians should be prepared to provide evidence-based answers to inquiries regarding AD treatment. There is insufficient evid...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000166671.86815.C1
更新日期:2005-06-01 00:00:00