ABSTRACT
Electronic mail (e-mail) is a powerful tool that can greatly enhance communication and has numerous potential applications within the medical profession. Physician-patient e-mail communication volume is increasing, but little research has addressed patient interests and concerns about this now commonplace technology. The goals of this study were to review the available literature regarding physician-patient e-mail practices, evaluate patient interest, assess patient perspectives about how e-mail communication might facilitate medical treatment and advice, and determine areas of patient concern regarding e-mail communication with their physicians. To this end, a population of cancer patients was sent a written survey designed to assess their access to e-mail and attitudes about physician-patient e-mail communication. We found that patients favored e-mail for increased convenience, efficiency, and timeliness about general health problems, while it was not favored for urgent matters.
Subject(s)
Attitude of Health Personnel , Electronic Mail , Physician-Patient Relations , Radiation Oncology , Aged , Communication , Female , Health Care Surveys , Humans , Information Services , Male , Middle Aged , Prostatic Neoplasms/radiotherapyABSTRACT
Thirty-two patients with the diagnosis of intracranial meningioma were treated with radiation therapy over the past 24 years at the Thomas Jefferson University Hospital. Indications for irradiation included incomplete resection, malignant histology, and progressive or recurrent disease after curative surgery. Patients with malignant histology did poorly, with only 2 of 7 alive. This contrasts with 17 of 25 patients with benign histology who are either alive and well or who have enjoyed a long-term disease-free survival. No difference in ultimate outcome could be found between patients with benign histology irradiated in the immediate postoperative period as opposed to those irradiated at time of progression or recurrence.
Subject(s)
Brain Neoplasms/radiotherapy , Meningioma/radiotherapy , Adolescent , Adult , Aged , Brain Neoplasms/surgery , Child , Child, Preschool , Combined Modality Therapy , Female , Humans , Male , Meningioma/surgery , Middle Aged , Neoplasm Recurrence, Local/radiotherapyABSTRACT
A case is presented of a patient with four separate primary carcinomas (two breast, one thyroid, one multiple skin cancers) arising in areas of the body subject to repeated low-dose radiation exposure during artificial pneumothorax treatment of pulmonary tuberculosis. Evidence for ionizing radiation as the likely common etiologic agent for all four tumors is presented and substantiated by a review of the literature.
Subject(s)
Breast Neoplasms/etiology , Fluoroscopy/adverse effects , Neoplasms, Multiple Primary/etiology , Neoplasms, Radiation-Induced/etiology , Pneumothorax, Artificial , Skin Neoplasms/etiology , Thyroid Neoplasms/etiology , Tuberculosis, Pulmonary/surgery , Carcinoma/etiology , Female , Humans , Middle Aged , RecurrenceABSTRACT
Fifty patients have been studied by bilateral phlebography following their first, or sometimes recurrent, pulmonary embolus. Nineteen were found to have fresh loose peripheral thrombus, and in eight of them the thrombus looked big enough to cause a major pulmonary artery obstruction and death. These 19 patients were treated by vein ligation in addition to anticoagulants.The incidence of recurrent embolism in the trial group is significantly lower than that found in a retrospective study of 50 patients treated with anticoagulants only. It is suggested that anticoagulants will not prevent all recurrent pulmonary emboli, and that phlebography, and if necessary surgery, should be part of the routine investigation and treatment of all patients after their first pulmonary embolus.