Background Using therapeutic hypothermia (TH) reduces the core body temperature of survivors of cardiac arrest to minimize the neurological damage caused by severe hypoxia. The TH protocol is initiated following return of spontaneous circulation (ROSC) in non-responsive patients. Clinical trials examining this technique have shown significant improvement in neurological function among survivors of cardiac arrests. Though there is strong evidence to support TH use to improve the neurologic outcomes in shockable and nonshockable rhythms, predictors of TH utilization are not well-characterized. Our study tried to evaluate TH utilization, as well as the effect of the teaching status of hospitals, on outcomes, including mortality, length of stay, and total hospitalization charges.
We conducted this study to evaluate the survival patterns among patients in stage 1a and 1b NSCLC who underwent surgery.METHODS: Adult patients (age$50 years) diagnosed with stages 1a and 1b were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Several cohorts categorized by race (Caucasians & African-Americans (AA)), gender & age (50-65, >65 years) were compared to see survival differences in patients during 2005-2014. All patients diagnosed after death or autopsy and those with no survival time were excluded. The relative survival rates at 2 and 4 years were analyzed for various cohorts categorized by age (50-64 and $ 65 years), race (White and African-Americans) (AA) and gender. The survival rates accompany standard errors. We used Z-test in SEER*Stat to compare RS rates.RESULTS: There were total of 13,048 cases of Stage 1a and 1b patients in the study period who underwent surgery. Among them, 6025 were men and 7023 women. Median age at the time of diagnosis was 69.0AE 8.51 years. There was an increased in 2 and 4 year relative survival in females as compared to males (2 year: 92.5.AE0.5 vs 86.8AE0.6, Z¼8.15 and 4 year: 83.5AE0.8 vs 73.2AE1.0, Z¼ 9.65). There was also significant increase in RS for younger as compared to older patients (2 year: 91.4AE0.6 vs 89.1AE0.5, Z ¼ 3.63 and 4 year: 79.4AE1.1 vs 78.3AE0.8%, Z ¼ 2.59). The ethnic differences were also different early on with increased relative survival in African Americans as compared to whites with no difference at 4 years (2 year: 92.2AE1.1 vs 89.6AE0.4, Z ¼ 2.37 and 4 year: 80.6AE2.1 vs 78.5AE0.7%, Z ¼ 1.85). There was also significant increase in RS for Stage 1a as compared to 1b tumors (2 year: 92.1AE0.4 vs 86.2AE0.7, Z ¼ 7.54 and 4 year: 82.6AE0.8 vs 72.4AE1.1%, Z ¼ 8.79) CONCLUSIONS: Our study shows that there is significant survival in African American population compared to whites initially after surgery for early lung cancer. Similar age and gender differences in survival is also seen with survival favoring the younger population and females.CLINICAL IMPLICATIONS: Reason behind improved survival in African American population and age/gender differences post surgery in stage 1a and 1b after surgery has to be further investigated further in clinical trials.
DISCLOSURES:No relevant relationships by Janak Adhikari, source¼Web Response no disclosure on file for Priyadarshani Sharma;
A miliary pattern on chest imaging is often concerning for primary tuberculosis. However, such nodules may also be seen in fungal infections and autoimmune or (rarely) metastatic processes. Here, we report a case of a miliary mottling on chest imaging associated with metastatic lung adenocarcinoma.
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