Fwd: Derivation and internal validation of a rule to predict hospital admission in prehospital patients.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Sat, Jun 28, 2008 at 4:00 PM
Subject: Derivation and internal validation of a rule to predict hospital admission in prehospital patients.
To: mesothelioma77@gmail.com


[1]Prehosp Emerg Care. 2008 Jul-Sep; 12(3): 314-9
Meisel ZF, Pollack CV, Mechem CC, Pines JM

Objective. To derive and internally validate a simple prediction rule, using routinely collected prehospital patient data, that discriminates between hospital admission and emergency department (ED) discharge for adult patients who arrive by ambulance. Methods. We performed a retrospective cohort study of consecutive adult nontrauma patients transported to two separate EDs over two months by a city-run emergency medical services (EMS) system. We tested whether specific prehospital variables could predict hospital admission using chi-square tests, logistic regression, and receiver-operating characteristic curves. We created a rule to predict the probabilities of hospital admission for individual patients. Results. Of 401 patients, the mean age was 47 years; 60% were black and 32% were white; 51% were female; and 33% were admitted to an inpatient service after evaluation in the ED. Independent predictors of admission were dyspnea (adjusted odds ratio [OR] 6.8; awarded 3 points), chest pain (OR 5.2; 3 points), and dizziness, weakness, or syncope (OR 3.5; 2 points). Also predictive were age >/=60 years (OR 5.5; 3 points) and the prehospital identification of a history of diabetes (OR 1.9; 1 point) or cancer (OR 3.9; 2 points). Patients who had a score of 5 or higher had a greater than 69% chance of being admitted to an inpatient unit. Conclusion. Routinely collected EMS patient information can help predict hospital admission for certain ED patients.



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Source: http://www.hubmed.org/display.cgi?uids=18584498
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Fwd: Prognostic Significance of HER2 Gene Amplification According to Stage of Breast Cancer.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Sat, Jun 28, 2008 at 4:00 PM
Subject: Prognostic Significance of HER2 Gene Amplification According to Stage of Breast Cancer.
To: mesothelioma77@gmail.com


[1]J Korean Med Sci. 2008 Jun; 23(3): 414-20
Kim YS, Won YS, Park KS, Song BJ, Kim JS, Oh SJ, Jeon HM, Jung SS, Park WC

It is well known that the amplification of the HER2 gene is closely associated with poor prognosis of breast cancer. However, there is controversy about the clinical significance of HER2 according to lymph node status in breast cancer. The aim of this study was to identify the differences in the prognostic significance of HER2 gene amplification according to the stages of breast cancer. We prepared a tissue array for fluorescence in situ hybridization (FISH) with breast cancer specimens from the surgery in 1994 to 1999. Total 338 cases of breast cancer were enrolled and the median follow-up period was 6.3 yr. The detection rates of HER2 gene amplification were as follows: 10.3% in stage I, 22.3% in stage II, and 43.8% in stage III. On survival analyses HER2-positive groups showed worse prognosis in stage III of breast cancer, but not in stage I or II. Multivariate analyses with a Cox-regression model also revealed that HER2 amplification was an independent prognostic factor only in stage III breast cancer. Regarding HER2 gene amplification as a prognostic factor of breast cancer, the clinical significance of the gene was found to be confined to advanced breast cancer.



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Source: http://www.hubmed.org/display.cgi?uids=18583876
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