Biomedical subjects

H W Carloss

Publications and source records attributed to H W Carloss.

11 recordsLinked to original sources

PubMed2000

The burden of cancer in Kentucky: the 1997 Kentucky cancer incidence report.

The purpose of collecting this important disease burden information is of course not simply for reports like this one. The real value lies in use of data for program planning, resource allocation, program design, and evaluation. Data in the annual KCR report and on the website should be a valuable resource for district and county health departments in their assessment of health problems in their area and as critical decisions are made about how to utilize limited intervention resources. The Kentucky Cancer Registry will continue to work very closely with the Community Outreach Division of the Kentucky Cancer Program to make this data available on an annual basis to District Cancer Councils to help guide their assessment and planning process. District and local health departments are encouraged to actively participate in the District Cancer Councils and in the cancer control activities guided by the regional community outreach coordinators.

Adolescent↗

PubMed2000

Medicaid audits.

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Fraud↗

PubMed1997

Art or science?

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Clinical Competence↗

PubMed1993

Groshong catheter-associated subclavian venous thrombosis.

PURPOSE: To identify factors associated with the development of clinically significant venous thrombosis in cancer patients with long-term indwelling subclavian Groshong catheters (GC). Also, to assess both the subsequent performance of affected catheters and the effect of heparin and warfarin therapy on subsequent catheter function and longevity. METHODS: Longitudinal study of the outcome of clinical practice. Subset analysis of those catheters developing catheter-related venous thrombosis (CRVT). RESULTS: Thirty-seven cases of CRVT were identified in a population of 255 consecutive patients in whom a GC was inserted. Seventy percent of the thrombi occurred after an episode of previous catheter dysfunction; only 30% of the thrombi occurred de novo. An unexpectedly high risk of thrombosis was associated with insertion into the left-subclavian circulation (25 of 35 versus 135 of 220, p = 0.02) or with an antecedent episode of aspiration difficulty ("ball-valve effect" [BVE]) (20 of 35 versus 60 of 220, p < 0.01). No correlation was identified between thrombosis and tumor type, tumor histology, or preexisting medical disorders. Once identified, 79% of the involved patients received anticoagulant therapy with sequential heparin and warfarin. Overall longevity of the catheters preserved by anticoagulation (mean dwell = 202 days) far exceeded catheter longevity among the population of catheters that never developed thrombosis (mean dwell = 142 days). The mean catheter longevity after thrombosis (169 days) also exceeded the mean dwell time of all other catheters that were complication-free. CONCLUSIONS: CRVT is more likely in patients in whom the catheter is inserted in the left-subclavian circulation or who have experienced a previous episode of aspiration difficulty with the catheter (BVE). Catheter preservation with sequential heparin and warfarin therapy precludes the need for catheter removal and extends dramatically the useful life of the catheter.

Catheterization, Central Venous↗

PubMed1988

Disseminated prostatic carcinoma simulating primary lung cancer. Indications for immunodiagnostic studies.

Recognition of disseminated adenocarcinomas potentially responsive to current treatment programs is an important objective in the management of cancer patients. Metastatic adenocarcinoma of the prostate gland is a malignant entity which often can be palliated effectively by hormonally based therapeutic strategies. In cases of metastatic prostate cancer presenting with typical clinical features, the correct diagnosis can be readily achieved, but in patients with less obvious presentations the diagnosis of prostatic carcinoma may be overlooked. In the current report, a group of elderly men presenting with a clinical syndrome resembling either metastatic primary adenocarcinoma of the lung or primary adenocarcinoma of the lung coexisting with prostate cancer were found in fact to have metastatic prostatic carcinoma as their sole disease process. In each case, cytologic characterization of clinically involved tissue specimens by the prostate specific antigen and prostatic acid phosphatase immunohistochemical markers enabled clinical investigators to arrive at the correct diagnosis. Other clinical features, such as a positive bone scan and an enlarged prostate gland on physical exam and/or radiographic studies were noted to be present in these patients. All the patients in the current series responded to hormonal treatment regimens once the diagnosis of metastatic prostate cancer had been established. In elderly male patients presenting with what appears to be primary adenocarcinoma of the lung, the diagnosis of metastatic prostate cancer should be considered and when necessary evaluated by the use of appropriate clinical and immunohistochemical studies.

Acid Phosphatase↗

PubMed1980