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Biomedical subjects

E Haponik

Publications and source records attributed to E Haponik.

6 recordsLinked to original sources
PubMed2001

Staging by positron emission tomography predicts survival in patients with non-small cell lung cancer.

BACKGROUND: Positron emission tomography (PET) scanning is used increasingly to detect and stage lung cancer, but the test performance characteristics and relationship of PET to patient outcomes remain undefined. OBJECTIVE: To determine the test performance characteristics and relationship of PET scanning stage to patient outcomes relative to the 1997 International System for the Staging of Lung Cancer. DESIGN: Survival analysis using pathologic staging as the criterion standard for comparison of survival as predicted by staging by PET and CT. SETTING: University-based hospital. PATIENTS: All consecutive patients undergoing PET scanning for the evaluation of possible non-small cell lung cancer (NSCLC) during a 5-year period. MAIN OUTCOME MEASURES: Long-term survival of patients with NSCLC after staging by PET. RESULTS: One hundred fifty-two thoracic PET scans were obtained for the staging of possible NSCLC during a 5-year period. One hundred twenty-three patients (81%) demonstrated increased (18)F-fluorodeoxyglucose uptake. The overall sensitivity and specificity of PET for detecting malignancy were 95% and 67%, respectively, compared with 100% and 27% for chest CT. PET and CT had similar accuracy for staging the overall extent of disease (91% and 89%, respectively). PET stage correlated highly with survival using either nodal location or overall stage (p = 0.003, p = 0.002), as did pathologic staging (p = 0.0001, p = 0.0001). CT scan results did not accurately predict survival (p = 0.608, p = 0.338). CONCLUSION: PET scanning is a highly sensitive technologic advance in detecting and staging of thoracic malignancy and may more accurately predict the likelihood of long-term survival in patients with NSCLC than chest CT does.

Carcinoma, Non-Small-Cell Lung↗
PubMed1998

Early transition to oral antibiotic therapy for community-acquired pneumonia: duration of therapy, clinical outcomes, and cost analysis.

Our objective was to compare therapeutic outcome and analyse cost-benefit of a 'conventional' (7-day course of i.v. antibiotic therapy) vs. an abbreviated (2-day i.v. antibiotic course followed by 'switch' to oral antibiotics) therapy for in-patients with community-acquired pneumonia (CAP). We used a multicenter prospective, randomized, parallel group with a 28 day follow-up, at the University-based teaching hospitals: The Medical Center of Louisiana in New Orleans, LA and hospitals listed in the acknowledgement. Ninety-five patients were randomized to receive either a 'conventional' course of intravenous antibiotic therapy with cefamandole 1 g i.v. every 6 h for 7 days (n = 37), or an abbreviated course of intravenous therapy with cefamandole (1 g i.v. every 6 h for 2 days) followed by oral therapy with cefaclor (500 mg every 8 h for 5 days). No difference was found in the clinical courses, cure rates, survival or the resolution of the chest radiograph abnormalities among the two groups. The mean duration of therapy (6.88 days for the conventional group compared to 7-30 days for the early oral therapy group) and the frequencies of overall symptomatic improvement (97% vs. 95%, respectively) were similar in both groups. Patients who received early oral therapy had shorter hospital stays (7.3 vs. 9.71 days, P = 0.01), and a lower total cost of care ($2953 vs. $5002, P < 0.05). It was concluded that early transition to an oral antibiotic after an abbreviated course of intravenous therapy in CAP is substantially less expensive and has comparable efficacy to conventional intravenous therapy. Altering physicians' customary management of hospitalized patients with CAP can reduce costs with no appreciable additional risk of adverse patient outcome.

Administration, Oral↗
PubMed1998

Attitudes of respiratory care practitioners and students regarding pulmonary prevention.

STUDY OBJECTIVES: (1) To examine attitudes of respiratory care practitioners (RCPs) and RCP students toward pulmonary disease prevention behaviors and their role in promoting them. (2) To compare RCPs' attitudes regarding pulmonary prevention with existing medical student survey data. DESIGN: Cross-sectional survey. SETTING: Three sites (Valhalla, NY; Winston-Salem, NC; Houston, TX). PARTICIPANTS: One hundred ninety RCPs and 164 RCP students compared with 5,744 medical students. MEASUREMENT AND RESULTS: Subjects completed a 35-item RCP Preventive Pulmonary Attitude (PPA) Survey using a five-point scale (1 = strongly disagree to 5 = strongly agree). A higher score indicates a more positive attitude toward prevention. RCP total scores averaged 117.6 (SD, 15.7; range, 52 to 160). RCP student total scores were significantly higher than RCP practitioners. No significant differences were observed by gender or by type of patient served (pediatric vs adult). RCPs with a history of tobacco smoking had significantly lower scores than RCPs who had never smoked. Most, but not all, respondents acknowledged the importance of patients with chronic lung disease receiving a yearly influenza vaccination. Total PPA scores for medical students were significantly lower than scores for both RCPs and RCP students. Significant differences were noted for a number of individual items. CONCLUSIONS: In general, RCPs had positive attitudes regarding the importance of prevention counseling and their role in providing this to patients. This is important given their potential as a resource in pulmonary prevention efforts. More attention to inclusion of training and evaluation of RCP effectiveness in promoting respiratory health is needed.

Adolescent↗
PubMed1993

Relationship of nasal continuous positive airway pressure to periodic limb movement disorder in a patient without sleep apnea.

The treatment of sleep apnea with nasal continuous positive airway pressure (CPAP) occasionally has been associated with the appearance of periodic limb movement (PLM) disorder, but it has not been clear whether CPAP induces PLM, or whether the PLM is simply disguised until apnea is treated. We report the emergence of PLM after the inadvertent application of CPAP in a patient without sleep apnea.

Adult↗