Stage I lung cancer patients with or without symptoms - are the patients different and should we treat them differently?

INTRODUCTION: A large proportion of stage I cancers are found incidentally, which appears to be a prognostic factor. We investigated stage I lung cancers according to whether, or not, there had been clinical suspicion of lung cancer prior to referral and to see, if we could detect any difference regarding patient characteristics, work-up and mortality for incidental vs non-incidental findings as well as for asymptomatic vs symptomatic patients. METHODS: Medical records and referral documents for 177 patients diagnosed with stage I lung cancer were reviewed and divided based on whether the initial CT scan leading to diagnosis had been made due to suspicion of lung cancer or not. Patient characteristics and mortality between groups were compared, as well as mortality between patients with and without symptoms at the time of diagnosis. RESULTS: One-hundred-and-eight patients were diagnosed incidentally, while 69 patients were non-incidental findings. Among the incidental findings, 55% had no symptoms, whereas none in the non-incidental group were asymptomatic. Personal characteristics were comparable between the groups. Significantly more patients in the incidental group had malignant comorbidity. Non-malignant chronic co-morbidity was more prevalent in the non-incidental group, in particular lung disease. There was no difference in tumour size, histology, or survival for incidental vs non-incidental or for asymptomatic vs symptomatic patients. CONCLUSION: A large proportion of stage I lung cancers are found incidentally, especially in patients with malignant co-morbidity. We found no difference in survival to indicate that we did or should handle these patient groups differently.

Aerobic and anaerobic transformations of sulfide in a sewer system--field study and model simulations.

The formation and fate of sulfide in a force main and a downstream-located gravity sewer were investigated in an extensive field study. Sulfide formation in the force main was significant. However, during 14 minutes of transport in the gravity sewer, the sulfide concentration decreased 30%, on average. An application of a conceptual sewer process model for simulating the formation and fate of sulfide was demonstrated. Overall, the model predicted that approximately 90% of the decrease of the sulfide concentration in the gravity sewer was the result of sulfide oxidation and that only a small fraction entered the sewer atmosphere, causing odor and corrosion. Even so, the model predicted concrete corrosion rates of up to 1.2 mm/y in the gravity sewer section.

Evaluation of unique identifiers used as keys to match identical publications in Pure and SciVal - a case study from health science.

Unique identifiers (UID) are seen as an effective tool to create links between identical publications in databases or identify duplicates in a database. The purpose of the present study is to investigate how well UIDs work for citation linking. We have two objectives: Explore the coverage, precision, and characteristics of publications matched versus not matched with UIDs as the match key.Illustrate how publication sets formed by using UIDs as the match key may affect the bibliometric indicators: Number of publications, number of citations and the average number of citations per publication.   The objectives are addressed in a literature review and a case study. The literature review shows that only a few studies evaluate how well UIDs work as a match key. From the literature we identify four error types: Duplicate digital object identifiers (DOI), incorrect DOIs in reference lists and databases, DOIs not registered by the database where a bibliometric analysis is performed, and erroneous optical or special character recognition. The case study explores the use of UIDs in the integration between the databases Pure and SciVal. Specifically journal publications in English are matched between the two databases. We find all error types except erroneous optical or special character recognition in our publication sets. In particular the duplicate DOIs constitute a problem for the calculation of bibliometric indicators as both keeping the duplicates to improve the reliability of citation counts and deleting them to improve the reliability of publication counts will distort the calculation of average number of citations per publication. The use of UIDs as a match key in citation linking is implemented in many settings, and the availability of UIDs may become critical for the inclusion of a publication or a database in a bibliometric analysis.

Culture Negative Listeria monocytogenes Meningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy.

A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy for bacteria, no bacterial growth, and negative polymerase chain reaction for bacterial DNA. The patient developed hydrocephalus on a second CT scan of the brain on the 5th day of admission. An external ventricular catheter was inserted and Listeria monocytogenes grew in the cerebrospinal fluid from the catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically for Listeria monocytogenes in all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection and inflammation even with negative microscopy, negative cultures, and negative broad range polymerase chain reaction in cases of Listeria meningitis. Follow-up spinal taps can be necessary to detect the presence of Listeria monocytogenes.