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February 2013 Archives

Subarachnoid Hemorrhage Diagnosis Requires Lumbar Puncture

Subarachnoid hemorrhage (SAH) cannot be ruled out by CT scan or history with physical examination alone, according to a recent study published in Annals of Emergency Medicine. A lumbar puncture with examination of the cerebrospinal fluid is the only way to rule subarachnoid bleeding. Previous studies have reported that a clinical decision rule can rule out SAH with 100% sensitivity. Other studies have reported that a CT scan of the brain within 6 hours can rule SAH out with 100% accuracy. This study says otherwise. The researchers retrospectively looked at cases of SAH in patients with normal neurological exams and also looked at the accuracy of the clinical rule test and the CT imaging test. Sixty two percent (62%) of these patients had cerebral aneurysms and were presenting with signs of small early sentinel bleeds. This is important proper diagnosis allows treatment time prior to catastrophic rupture.

Breast Cancer Treatment Delays Reduce Survival

Breast cancer studies have looked at how cancer genetics, size, co-existing medical conditions and socioeconomic status affect outcome, but for the first time a study has looked at how delayed treatment affects survival. A new study looked at how a delay in treatment after biopsy confirmed diagnosis affects patient survival and found that for late stage cancers, this amount of treatment delay led to lower survival compared with other women similarly staged who did not suffer a delay in treatment. The study involved Medicaid patients in North Carolina who were diagnosed in 2000 - 2002 and were followed until July 2006.

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