Cancer diagnosed in the emergency department of a regional health service

OBJECTIVE: Patients diagnosed with cancer in the Emergency Department (ED) have more advanced disease at diagnosis and poorer outcomes. High rates of initial presentation to ED suggest potential problems with access to care. The aim of this project was to interpret findings in regional/rural Victoria and explore implications for practice.

DESIGN: Cross-sectional study linking two independent data sets.

SETTING: Regional city of Geelong and surrounding rural areas in south-west Victoria.

PARTICIPANTS: All newly diagnosed cancer patients in 2009.

MAIN OUTCOME MEASURES: Number of cancer patients diagnosed in the ED.

RESULTS: One in five newly diagnosed cancer patients present to ED 6 months prior to cancer diagnosis. One in 10 is diagnosed as a result of their ED visit. Patients presenting to ED were older, more often men and from disadvantaged areas. Symptoms on presentation included chest complaints, bowel obstruction, abdominal pain, anaemia and generalised weakness. Cancer diagnosed in the ED is associated with advanced stage and shorter survival.

CONCLUSION: Reasons for presentation to ED would be multifactorial and include complex cases with coexisting symptoms making diagnosis difficult. The general public appear to have a low level of awareness of alternative primary care services or difficulty accessing such information. Some of the changes towards reducing the number of patients presenting to ED will include patient education.

Working on a Lathe in the Carpentry Department of the New York Trade School

A student or teacher at the New York Trade School is shown working on a lathe in the Carpentry Department. Black and white photograph credited to the New York City Works Progress Administration.

About DAPP: Meet the Department of Public Policy Analysis

The Department of Public Policy Analysis of Getulio Vargas Foundation (DAPP-FGV) is a research boutique concerned with the innovation of state structures and the relations between these and Civil Society, based on an interdisciplinary approach of applied social science, together with Information and Communication Technologies.

Paracoccidioidomycosis: Survey and clinical aspects from the Department of Dermatology of the School of Medicine of Botucatu (Sao Paulo - Brazil)

Background - Paracoccidioidomycosis is the most frequent among the systemic mycoses in Brazil. Objective: To study the cases of paracoccidioidomycosis diagnosed from 1976 to 1996 at the Department of Dermatology of the School of Medicine of Botucatu. Methods - Descriptive study obtained from specific protocols comprising anamnesis, clinical- dermatological-laboratorial examination, treatment and follow-up of the patients. Results - Paracoccidioidomycosis was diagnosed in 1.04% of the dermatologic outpatients assisted from 1976 to 1996. In 315 cases, 89.8% were male, 61.9% were over forty and 53.7% were rural workers. The complaints were related more to oropharyngolaryngeal (53.6%) or cutaneous (23.8%) lesions or adenopathy (10.2%). Seventy patients had already been treated in other health services. The chronic multifocal clinical from was the most common: 80.6% of the cases, followed by the acute-subacute (juvenile type) 15.5%. The disease was pulmonary in 80.0%, oropharyngolaryngeal in 69.2% and cutaneous in 45.7%. Th treatment: Amphotericin B in 146 patients, Ketoconazole - 88, Itraconazole - 56, Sulfonamide derivatives - 146 and Terbinafine in 3. The lethality index resulting from the disease or its treatment was 2.0%. Conclusions - The high number of cases, showing the regional relevance of the disease and the high percentage of tegumentary complaints and the high number of relapsing are remarkable.

Panorama de la Agricultura de América Latina y el Caribe en las últimas décadas: indicadores de comportamiento en cuadros y gráficos = Survey of agriculture in Latin America and the Caribbean over recent decades: performance indicators in charts and tables

Incluye Bibliografía

Panorama de la agricultura de América Latina y el Caribe, 1990-2000 = Survey of agriculture in Latin America and the Caribbean, 1990-2000

Incluye Bibliografía

Agriculturization as a syndrome: a comparative study of agriculture in Argentina and Australia

Includes bibliography

Situación y evolución de la agricultura y la alimentación en América Latina = Situation and evolution of agriculture and food supplies in Latin America

Incluye Bibliografía

Committee IV (economic problems of agriculture): summary record of the fifth meeting, held at Bogotá on Thursday 8 September 1955 at 3.40 pm.

Documento indica en el título "third meeting"