28 results on '"Swensen, Stephen J."'
Search Results
2. Cystic and Cavitary Lung Diseases: Focal and Diffuse.
- Author
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Ru, Jay H. and Swensen, Stephen J.
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CYSTS (Pathology) , *LUNG disease diagnosis , *RADIOGRAPHY , *DIAGNOSIS - Abstract
Cysts and cavities are commonly encountered abnormalities on chest radiography and chest computed tomography. Occasionally, the underlying nature of the lesions can be readily apparent as in bullae associated with emphysema. Other times, cystic and cavitary lung lesions can be a diagnostic challenge. In such circumstances, distinguishing cysts (wall thickness ≤4 mm) from cavities (wall thickness >4 mm or a surrounding infiltrate or mass) and focal or multifocal disease from diffuse involvement facilitates the diagnostic process. Other radiological characteristics, including size, inner wall contour, nature of contents, and location, when correlated with the clinical context and tempo of the disease process provide the most helpful diagnostic clues. Focal or multifocal cystic lesions include blebs, bullae, pneumatoceles, congenital cystic lesions, traumatic lesions, and several infections processes, including coccidioidomycosis, Pneumocystis carinii pneumonia, and hydatid disease. Malignant lesions including metastatic lesions may rarely present as cystic lesions. Focal or multifocal cavitary lesions include neoplasms such as bronchogenic carcinomas and lymphomas, many types of infections or abscesses, immunologic disorders such as Wegener granulomatosis and rheumatoid nodule, pulmonary infarct, septic embolism, progressive massive fibrosis with pneumoconiosis, lymphocytic interstitial pneumonia, localized bronchiectasis, and some congenital lesions. Diffuse involvement with cystic or cavitary lesions may be seen in pulmonary lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, honeycomb lung associated with advanced fibrosis, diffuse bronchiectasis, and, rarely, metastatic disease. High-resolution computed tomography of the chest frequently helps define morphologic features that may serve as important dues regarding the nature of cystic and cavitary lesions in the lung. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
- View/download PDF
3. The probability of malignancy in solitary pulmonary nodules.
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Swensen, Stephen J. and Silverstein, Marc D.
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LUNG tumors - Abstract
Investigates the probability of malignancy in solitary pulmonary nodules (SPN) of 629 patients with newly discovered SPN on chest radiography. Classification of SPNs; Treatment of SPN as to benign and malignancy; Development of a clinical prediction model; Usage of the Bayes theorem; Limitations of the research.
- Published
- 1997
- Full Text
- View/download PDF
4. Pulmonary amyloidosis.
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Utz, James P. and Swensen, Stephen J.
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AMYLOIDOSIS , *LUNG diseases , *PROGNOSIS - Abstract
Defines the prognosis for and radiographic presentation of patients with pulmonary amyloidosis. Pulmonary amyloidosis associated with systemic amyloidosis; Localized pulmonary amyloidosis; Diffuse interstitial pattern; Biopsy techniques.
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- 1996
- Full Text
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5. Patient-centered Imaging
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Swensen, Stephen J.
- Published
- 2012
- Full Text
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6. Transparency and the "End Result Idea".
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Swensen, Stephen J. and Cortese, Denise A.
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ORGANIZATIONAL transparency , *MEDICAL practice , *PHYSICIANS , *MEDICINE information services , *HEALTH policy - Abstract
The author comments on the association between transparency in the medical practices and information and the end result idea among physicians in the U.S. He asserts that end result idea of Dr. Ernest Codman implies that doctors should follow up with all patients to asses the results of their treatment and outcomes should be revealed in public. However, he added that its importance is evident on the improvement of the medical standards.
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- 2008
- Full Text
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7. Lung Cancer Screening Results: Easily Misunderstood.
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Midthun, David E., Swensen, Stephen J., Hartman, Thomas E., and Jett, James R.
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MEDICAL screening , *LUNG cancer , *MORTALITY , *HEALTH outcome assessment - Abstract
The author reflects on the report on lung cancer screening by the International Early Lung Cancer Action Project (IELCAP) group published in "The New England Journal of Medicine." According to the author, observational studies such as the IELCAP can provide important information but cannot prove efficacy of screening through mortality reduction. He said that the improved survival reported by the IELCAP group may simply be a reflection of bias from screening.
- Published
- 2007
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8. Computed tomographic screening for lung cancer: home run or foul ball?
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Swensen, Stephen J., Jett, James R., Midthun, David E., and Hartman, Thomas E.
- Subjects
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TOMOGRAPHY , *LUNG cancer diagnosis - Abstract
Discusses the sensitivity of computed tomography (CT) in screening lung cancer at earlier stages. Whole-body CT screening; Radiation exposure issues; Comparison of performance between CT and chest radiography.
- Published
- 2003
- Full Text
- View/download PDF
9. Screening for cancer with computed tomography.
- Author
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Swensen, Stephen J.
- Subjects
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TOMOGRAPHY , *CANCER diagnosis , *MEDICAL screening , *PHYSICIAN-patient relations , *LUNG cancer - Abstract
Editorial. Discusses the practice of whole body screening with computed tomography to detect cancer. Data from research by the National Institutes of Health using computed tomography to screen for lung cancer; Reasons that it is premature to advocate medical screening with computed tomography on a large scale; Topics of the high cost and high false positive rates; Advice for doctors who counsel patients about the pros and cons of computed tomography.
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- 2003
- Full Text
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10. Cottage Industry to Postindustrial Care — The Revolution in Health Care Delivery.
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Swensen, Stephen J., Meyer, Gregg S., Nelson, Eugene C., Hunt, Gordon C., Pryor, David B., Weissberg, Jed I., Kaplan, Gary S., Daley, Jennifer, Yates, Gary R., Chassin, Mark R., James, Brent C., and Berwick, Donald M.
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HEALTH care industry , *COTTAGE industries , *PATIENTS , *PHYSICIANS - Abstract
The article comments on the need for the health care industry to transform from cottage industry to postindustrial care to revolutionize health care delivery in the U.S. According to the authors, the transformation will be made by integrating the elements of standardizing care, measuring performance, and transparent reporting. They stress the importance of delivering evidence-based care to achieve this goal. This initiative will both benefit the patients and the physician's practice.
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- 2010
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11. Are Airflow Obstruction and Radiographic Evidence of Emphysema Risk Factors for Lung Cancer?
- Author
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Maldonado, Fabien, Bartholmai, Brian J., Swensen, Stephen J., Midthun, David E., Decker, Paul A., and Jett, James R.
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PULMONARY emphysema , *LUNG cancer , *OBSTRUCTIVE lung diseases , *DISEASE risk factors , *TOMOGRAPHY - Abstract
The article presents the conducted nested case-control study on airflow obstruction and the presence of radiographic evidence of emphysema as risk factors for lung cancer. In the study, lung cancer patients from the Mayo Clinic in Minnesota are matched to six control subjects for age, sex and smoking history and quantitative computed tomography (CT) scan analysis of emphysema was conducted. The results of the study showed that airflow obstruction is proved to be an independent risk factor for lung cancer.
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- 2010
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12. 5-Year Lung Cancer Screening Experience.
- Author
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Lindell, Rebecca M., Hartman, Thomas E., Swensen, Stephen J., Jett, James R., Midthun, David E., and Mandrekar, Jayawant N.
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LUNG cancer , *CANCER patients , *TOMOGRAPHY , *DISEASE progression , *CANCER in women , *CANCER in men - Abstract
The article presents a study that documents the development of lung cancer discovered in high-risk patients who receive yearly screening chest computed tomography (CT) scans. The study examined eighteen lung cancers by at least four serial CT scans among 14 women and 4 men with an age range of 53 to 79 years. The results suggest that though factors preferred lesser fast-growing cancers in women, lung cancers are not restricted to exponential development.
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- 2009
- Full Text
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13. Evaluation of a Quantitative D-Dimer Latex Immunoassay for Acute Pulmonary Embolism Diagnosed by Computed Tomographic Angiography.
- Author
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Froehling, David A., Daniels, Paul R., Swensen, Stephen J., Heit, John A., Mandrekar, Jayawant N., Ryu, Jay H., and Elkin, Peter L.
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PULMONARY embolism , *THROMBOEMBOLISM , *ARTERIAL occlusions , *IMMUNOASSAY , *ANGIOGRAPHY , *MEDICAL radiography - Abstract
OBJECTIVE: To determine the sensitivity and specificity of a quantitative plasma fibrin D-dimer latex immunoassay (LIA) for the diagnosis of acute pulmonary embolism. SUBJECTS AND METHODS: Study subjects were Mayo Clinic Rochester inpatients and outpatients with suspected acute pulmonary embolism; all had undergone quantitative D-dimer LIA testing and multidetector-row computed tomographic (CT) angiography between August 3, 2001, and November 10, 2003. Multidetector-row CT angiography was the diagnostic reference standard. RESULTS: Of 1355 CT studies, 208 (15%) were positive for acute pulmonary embolism. Median D-dimer levels were significantly higher for patients with acute pulmonary embolism (1425 ng/mL) than for patients without (500 ng/mL) (P<.001). The highest specificity that optimizes sensitivity for acute pulmonary embolism was achieved by using a discriminant value of 300 ng/mL, which yielded a sensitivity of 0.94 (95% confidence interval [CI], 0.89-0.97), a specificity of 0.27 (95% CI, 0.25-0.30), and a negative predictive value of 0.96 (95% CI, 0.93-0.98). CONCLUSION: The quantitative D-dimer LIA with a discriminant value of 300 ng/mL had high sensitivity and high negative predictive value but low specificity for the diagnosis of acute pulmonary embolism. On the basis of these results, we believe that a negative quantitative D-dimer LIA result and a low pretest probability of thromboembolism together are sufficient to exclude acute pulmonary embolism. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
14. Clinicoradiological Features of Pulmonary Infarctions Mimicking Lung Cancer.
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George, C. Joseph, Tazelaar, Henry D., Swensen, Stephen J., and Ryu, Jay H.
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LUNG diseases , *INFARCTION , *CANCER , *MEDICAL radiology , *CLINICAL medicine - Abstract
Objective: to describe presenting features of pulmonary infarction that may simulate those of lung cancer. Patients and methods: We reviewed the medical records of 43 patients with pulmonary infarction diagnosed by surgical lung biopsy at the Mayo Clinic in Rochester, Minn, from January 1, 1996, to December 31, 2002. Of 16 patients presenting with an undiagnosed solitary pulmonary nodule or mass, 6 had features suggestive of lung cancer on additional imaging, including abnormalities on contrast-enhancement computed tomography (CT), position emission tomography (PET), or nonsurgical lung biopsy before surgical resection. We examined the presenting symptoms, epidemiological, clinical, and radiological features, and clinical course of these 6 patients. Results: All 6 patients, ranging in age from 41 to 85 years, had a history of smoking and underlying cardiopulmonary disease. In 5 of the 6 patients, CT showed a nodule in the subpleural region of the lung. Three patients had abnormalities on contrast-enhancement CT, 2 had abnormalities on PET, and 1 had abnormal cytologic findings on a transthoracic needle biopsy of the lung; all these studies showed abnormalities suggestive of lung cancer. Surgical resection of the nodule or mass revealed pulmonary infarction associated with organizing thrombi in all 6 patients. Conclusions: Pulmonary infarctions can closely mimic the clinicoradiological characteristics of lung cancer, an association not reported previously. Furthermore, cytologic changes that occur in pulmonary infarctions may produce malignant-appearing cells on needle biopsy of the lung. The possibility of pulmonary infarction should be considered in the differential diagnosis of a solitary lung nodule or mass located in the subpleural region, even in the absence of clinically recognized venous thromboembolism. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
15. Sensitivity and Specificity of the Semiquantitative Latex Agglutination D-Dimer Assay for the Diagnosis of Acute Pulmonary Embolism as Defined by Computed Tomographic Angiography.
- Author
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Froehling, David A., Elkin, Peter L., Swensen, Stephen J., Heit, John A., Pankratz, V. Shane, and Ryu, Jay H.
- Subjects
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PULMONARY embolism , *BIOLOGICAL assay , *DIMERS , *FIBRIN , *TOMOGRAPHY , *ANGIOGRAPHY - Abstract
• Objective: To determine the sensitivity and specificity of the semiquantitative latex agglutination plasma fibrin D-dimer assay for the diagnosis of acute pulmonary embolism by using computed tomographic (CT) angiography as the diagnostic reference standard. • Patients and Methods: From January 1, 1998, to June 26, 2000, patients who had both semiquantitative latex agglutination plasma fibrin D-dimer testing and CT angiography for suspected acute pulmonary embolism were selected for the study. A D-dimer value greater than 250 ng/mL was considered positive for thromboembolic disease. Diagnosis of acute pulmonary embolism was based solely on the interpretation of the CT angiogram. The Ddimer assay results were then compared with the CT angiographic diagnoses. • Results: Of 946 CT studies, 172 (18%) were positive for acute pulmonary embolism. The D-dimer assay was positive for 612 (65%) of the 946 patients. For acute pulmonary embolism, the D-dimer assay had a sensitivity of 0.83 (95% confidence interval [CI], 0.76-0.88), a specificity of 0.39 (95% CI, 036-0.43), a negative likelihood ratio of 0.44 (95% CI, 0.32-0.62), and a negative predictive value of 0.91 (95% CI, 0.87-0.94). • Conclusions: The semiquantitative latex agglutination plasma fibrin D-dimer assay had moderate sensitivity and low specificity for the diagnosis of acute pulmonary embolism. When used alone, the results of this test were insufficient to exclude this serious and potentially fatal disorder. Approximately two thirds of our patients had positive D-dimer assays and required further evaluation to exclude acute pulmonary embolism. CI = confidence interval; CT = computed tomography; ELISA = enzyme-linked immunosorbent assay. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
16. Are airflow obstruction and radiographic evidence of emphysema risk factors for lung cancer? A nested case-control study using quantitative emphysema analysis.
- Author
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Maldonado F, Bartholmai BJ, Swensen SJ, Midthun DE, Decker PA, Jett JR, Maldonado, Fabien, Bartholmai, Brian J, Swensen, Stephen J, Midthun, David E, Decker, Paul A, and Jett, James R
- Abstract
Objectives: Several studies have identified airflow obstruction as a risk factor for lung cancer independent of smoking history, but the risk associated with the presence of radiographic evidence of emphysema has not been extensively studied. We proposed to assess this risk using a quantitative volumetric CT scan analysis.Methods: Sixty-four cases of lung cancer were identified from a prospective cohort of 1,520 participants enrolled in a spiral CT scan lung cancer screening trial. Each case was matched to six control subjects for age, sex, and smoking history. Quantitative CT scan analysis of emphysema was performed. Spirometric measures were also conducted. Data were analyzed using conditional logistic regression making use of the 1:6 set groups of 64 cases and 377 matched control subjects.Results: Decreased FEV(1) and FEV(1)/FVC were significantly associated with a diagnosis of lung cancer with ORs of 1.15 (95% CI, 1.00-1.32; P = .046) and 1.29 (95% CI, 1.02-1.62; P = .031), respectively. The quantity of radiographic evidence of emphysema was not found to be a significant risk for lung cancer with OR of 1.042 (95% CI, 0.816-1.329; P = .743). Additionally, there was no significant association between severe emphysema and lung cancer with OR of 1.57 (95% CI, 0.73-3.37).Conclusions: We confirm previous observations that airflow obstruction is an independent risk factor for lung cancer. The absence of a clear relationship between radiographic evidence of emphysema and lung cancer using an automated quantitative volumetric analysis may result from different population characteristics than those of prior studies, radiographic evidence of emphysema quantitation methodology, or absence of any relationship between emphysema and lung cancer risk. [ABSTRACT FROM AUTHOR]- Published
- 2010
- Full Text
- View/download PDF
17. 5-year lung cancer screening experience: growth curves of 18 lung cancers compared to histologic type, CT attenuation, stage, survival, and size.
- Author
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Lindell RM, Hartman TE, Swensen SJ, Jett JR, Midthun DE, Mandrekar JN, Lindell, Rebecca M, Hartman, Thomas E, Swensen, Stephen J, Jett, James R, Midthun, David E, and Mandrekar, Jayawant N
- Abstract
Background: Although no study has prospectively documented the rate at which lung cancers grow, many have assumed exponential growth. The purpose of this study was to document the growth of lung cancers detected in high-risk participants receiving annual screening chest CT scans.Methods: Eighteen lung cancers were evaluated by at least four serial CT scans (4 men, 14 women; age range, 53 to 79 years; mean age, 66 years). CT scans were retrospectively reviewed for appearance, size, and volume (volume [v] = pi/6[ab(2)]). Growth curves (x = time [in days]; y = volume [cubic millimeters]) were plotted and subcategorized by histology, CT scan attenuation, stage, survival, and initial size.Results: Inclusion criteria favored smaller, less aggressive cancers. Growth curves varied, even when subcategorized by histology, CT scan attenuation, stage, survival, or initial size. Cancers associated with higher stages, mortality, or recurrence showed fairly steady growth or accelerated growth compared with earlier growth, although these growth patterns also were seen in lesser-stage lung cancers. Most lung cancers enlarged at fairly steady increments, but several demonstrated fairly flat growth curves, and others demonstrated periods of accelerated growth.Conclusions: This study is the first to plot individual lung cancer growth curves. Although parameters favored smaller, less aggressive cancers in women, it showed that lung cancers are not limited to exponential growth. Tumor size at one point or growth between two points did not appear to predict future growth. Studies and equations assuming exponential growth may potentially misrepresent an indeterminate nodule or the aggressiveness of a lung cancer. [ABSTRACT FROM AUTHOR]- Published
- 2009
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- View/download PDF
18. Significance of Multiple Carcinoid Tumors and Tumorlets in Surgical Lung Specimens: Analysis of 28 Patients.
- Author
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Aubry, Marie-Christine, Thomas, Jr., Charles F., Jett, James R., Swensen, Stephen J., and Myers, Jeffrey L.
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CARCINOID , *NEUROENDOCRINE tumors , *CANCER patients , *CANCER research , *RESPIRATORY organs - Abstract
The article presents information related to a study which has examined the significance of multiple carcinoid tumorlets in surgical lung specimens. It has been revealed by the study that multiple carcinoid tumorlets occur commonly in patients with multiple nodules resembling metastatic disease. The study suggests that it is possible to manage the patients with observation and treatment appropriate to the underlying condition.
- Published
- 2007
- Full Text
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19. Evaluation of a quantitative D-dimer latex immunoassay for acute pulmonary embolism diagnosed by computed tomographic angiography.
- Author
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Froehling DA, Daniels PR, Swensen SJ, Heit JA, Mandrekar JN, Ryu JH, Elkin PL, Froehling, David A, Daniels, Paul R, Swensen, Stephen J, Heit, John A, Mandrekar, Jayawant N, Ryu, Jay H, and Elkin, Peter L
- Abstract
Objective: To determine the sensitivity and specificity of a quantitative plasma fibrin D-dimer latex immunoassay (LIA) for the diagnosis of acute pulmonary embolism.Subjects and Methods: Study subjects were Mayo Clinic Rochester inpatients and outpatients with suspected acute pulmonary embolism; all had undergone quantitative D-dimer LIA testing and multidetector-row computed tomographic (CT) angiography between August 3, 2001, and November 10, 2003. Multidetector-row CT angiography was the diagnostic reference standard.Results: Of 1355 CT studies, 208 (15%) were positive for acute pulmonary embolism. Median D-dimer levels were significantly higher for patients with acute pulmonary embolism (1425 ng/mL) than for patients without (500 ng/mL) (P<.001). The highest specificity that optimizes sensitivity for acute pulmonary embolism was achieved by using a discriminant value of 300 ng/mL, which yielded a sensitivity of 0.94 (95% confidence interval [CI], 0.89-0.97), a specificity of 0.27 (95% CI, 0.25-0.30), and a negative predictive value of 0.96 (95% CI, 0.93-0.98).Conclusion: The quantitative D-dimer LIA with a discriminant value of 300 ng/mL had high sensitivity and high negative predictive value but low specificity for the diagnosis of acute pulmonary embolism. On the basis of these results, we believe that a negative quantitative D-dimer LIA result and a low pretest probability of thromboembolism together are sufficient to exclude acute pulmonary embolism. [ABSTRACT FROM AUTHOR]- Published
- 2007
20. Computed Tomography Screening and Lung Cancer Outcomes.
- Author
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Bach, Peter B., Jett, James R., Pastorino, Ugo, Tockman, Melvyn S., Swensen, Stephen J., and Begg, Colin B.
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LUNG cancer diagnosis , *LUNG cancer , *MEDICAL research , *TOMOGRAPHY , *MEDICAL radiography ,HEALTH of cigarette smokers - Abstract
The article presents a medical research study that examined whether computed tomography screening increases the frequency of lung cancer diagnosis and resection and if it reduces the risk of a diagnosis of advanced lung cancer or death from lung cancer. Asymptomatic current and former smokers were screened annually for lung cancer via computed tomography. The authors found that low-dose computed tomography screening can increase the frequency of lung cancer diagnosis and treatment, but that a reduction in advanced lung cancer or death from cancer may not be a result of the screening. The authors conclude that asymptomatic individuals should not be screened outside of clinical research studies. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
21. α1-Antitrypsin and Neutrophil Elastase Imbalance and Lung Cancer Risk.
- Author
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Ping Yang, Bamlet, William R., Zhifu Sun, Ebbert, Jon O., Marie-Christine Aubry, Taylor, William R., Marks, Randolph S., Deschamps, Claude, Swensen, Stephen J., Wieben, Eric D., Cunningham, Julie M., Melton, Lee Joseph, and de Andrade, Mariza
- Subjects
- *
LUNG cancer , *ALPHA 1-antitrypsin , *ALPHA globulins , *LEUCOCYTE elastase , *SERINE proteinases - Abstract
The article investigates whether genetic variations indicative of α1-Antitrypsin deficiency (A1ATD) or an excess of neutrophil elastase modify lung cancer risk. Sex and ethnicity were comparable between case patients and control subjects, but case patients were more likely to be smokers, and to have a history of COPD, environmental tobacco smoke exposure, and a positive family history of lung cancer. Genotypes indicative of A1ATD and/or excess of neutrophil elastase are significantly associated with lung cancer risk.
- Published
- 2005
- Full Text
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22. Clinicoradiological features of pulmonary infarctions mimicking lung cancer.
- Author
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George CJ, Tazelaar HD, Swensen SJ, Ryu JH, George, C Joseph, Tazelaar, Henry D, Swensen, Stephen J, and Ryu, Jay H
- Abstract
Objective: To describe presenting features of pulmonary infarction that may simulate those of lung cancer.Patients and Methods: We reviewed the medical records of 43 patients with pulmonary infarction diagnosed by surgical lung biopsy at the Mayo Clinic in Rochester, Minn, from January 1, 1996, to December 31, 2002. Of 16 patients presenting with an undiagnosed solitary pulmonary nodule or mass, 6 had features suggestive of lung cancer on additional imaging, including abnormalities on contrast-enhancement computed tomography (CT), positron emission tomography (PET), or nonsurgical lung biopsy before surgical resection. We examined the presenting symptoms, epidemiological, clinical, and radiological features, and clinical course of these 6 patients.Results: All 6 patients, ranging in age from 41 to 85 years, had a history of smoking and underlying cardiopulmonary disease. In 5 of the 6 patients, CT showed a nodule in the subpleural region of the lung. Three patients had abnormalities on contrast-enhancement CT, 2 had abnormalities on PET, and 1 had abnormal cytologic findings on a transthoracic needle biopsy of the lung; all these studies showed abnormalities suggestive of lung cancer. Surgical resection of the nodule or mass revealed pulmonary infarction associated with organizing thrombi in all 6 patients.Conclusions: Pulmonary infarctions can closely mimic the clinicoradiological characteristics of lung cancer, an association not reported previously. Furthermore, cytologic changes that occur in pulmonary infarctions may produce malignant-appearing cells on needle biopsy of the lung. The possibility of pulmonary infarction should be considered in the differential diagnosis of a solitary lung nodule or mass located in the subpleural region, even in the absence of clinically recognized venous thromboembolism. [ABSTRACT FROM AUTHOR]- Published
- 2004
23. Effectiveness of smoking cessation self-help materials in a lung cancer screening population
- Author
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Clark, Matthew M., Cox, Lisa Sanderson, Jett, James R., Patten, Christi A., Schroeder, Darrell R., Nirelli, Liza M., Vickers, Kristin, Hurt, Richard D., and Swensen, Stephen J.
- Subjects
- *
LUNG cancer , *SMOKING , *MEDICAL screening , *SMOKING cessation products - Abstract
Randomized controlled trials of smoking interventions have not been well-documented for lung cancer screening populations. In this study, we randomly assigned 171 current smokers who were undergoing low-dose fast spiral chest CT (SCTS) for lung cancer screening to receive either standard written self-help materials or a written list of Internet resources for smoking cessation. At the 1-year follow-up, more of the subjects receiving Internet-based resources reported making a stop attempt (68% versus 48%,
P=0.011 ). However, there were no statistically significant differences in 7-day point prevalence quit rates (5% versus 10%) or advancement in motivational readiness to stop smoking (27% versus 30%), respectively, between the groups. Clearly, more investigation is warranted into how to tailor smoking interventions for cancer screening participants. [Copyright &y& Elsevier]- Published
- 2004
- Full Text
- View/download PDF
24. Sensitivity and specificity of the semiquantitative latex agglutination D-dimer assay for the diagnosis of acute pulmonary embolism as defined by computed tomographic angiography.
- Author
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Froehling DA, Elkin PL, Swensen SJ, Heit JA, Pankratz VS, Ryu JH, Froehling, David A, Elkin, Peter L, Swensen, Stephen J, Heit, John A, Pankratz, V Shane, and Ryu, Jay H
- Abstract
Objective: To determine the sensitivity and specificity of the semiquantitative latex agglutination plasma fibrin D-dimer assay for the diagnosis of acute pulmonary embolism by using computed tomographic (CT) angiography as the diagnostic reference standard.Patients and Methods: From January 1, 1998, to June 26, 2000, patients who had both semiquantitative latex agglutination plasma fibrin D-dimer testing and CT angiography for suspected acute pulmonary embolism were selected for the study. A D-dimer value greater than 250 ng/mL was considered positive for thromboembolic disease. Diagnosis of acute pulmonary embolism was based solely on the interpretation of the CT angiogram. The D-dimer assay results were then compared with the CT angiographic diagnoses.Results: Of 946 CT studies, 172 (18%) were positive for acute pulmonary embolism. The D-dimer assay was positive for 612 (65%) of the 946 patients. For acute pulmonary embolism, the D-dimer assay had a sensitivity of 0.83 (95% confidence interval [CI], 0.76-0.88), a specificity of 039 (95% CI, 036-0.43), a negative likelihood ratio of 0.44 (95 % CI, 032-0.62), and a negative predictive value of 0.91 (95% CI, 0.87-0.94).Conclusions: The semiquantitative latex agglutination plasma fibrin D-dimer assay had moderate sensitivity and low specificity for the diagnosis of acute pulmonary embolism. When used alone, the results of this test were insufficient to exclude this serious and potentially fatal disorder. Approximately two thirds of our patients had positive D-dimer assays and required further evaluation to exclude acute pulmonary embolism. [ABSTRACT FROM AUTHOR]- Published
- 2004
25. Cystic and cavitary lung diseases: focal and diffuse.
- Author
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Ryu JH, Swensen SJ, Ryu, Jay H, and Swensen, Stephen J
- Abstract
Cysts and cavities are commonly encountered abnormalities on chest radiography and chest computed tomography. Occasionally, the underlying nature of the lesions can be readily apparent as in bullae associated with emphysema. Other times, cystic and cavitary lung lesions can be a diagnostic challenge. In such circumstances, distinguishing cysts (wall thickness < or = 4 mm) from cavities (wall thickness > 4 mm or a surrounding infiltrate or mass) and focal or multifocal disease from diffuse involvement facilitates the diagnostic process. Other radiological characteristics, including size, inner wall contour, nature of contents, and location, when correlated with the clinical context and tempo of the disease process provide the most helpful diagnostic clues. Focal or multifocal cystic lesions include blebs, bullae, pneumatoceles, congenital cystic lesions, traumatic lesions, and several infectious processes, including coccidioidomycosis, Pneumocystis carinii pneumonia, and hydatid disease. Malignant lesions including metastatic lesions may rarely present as cystic lesions. Focal or multifocal cavitary lesions include neoplasms such as bronchogenic carcinomas and lymphomas, many types of infections or abscesses, immunologic disorders such as Wegener granulomatosis and rheumatoid nodule, pulmonary infarct, septic embolism, progressive massive fibrosis with pneumoconiosis, lymphocytic interstitial pneumonia, localized bronchiectasis, and some congenital lesions. Diffuse involvement with cystic or cavitary lesions may be seen in pulmonary lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, honeycomb lung associated with advanced fibrosis, diffuse bronchiectasis, and, rarely, metastatic disease. High-resolution computed tomography of the chest frequently helps define morphologic features that may serve as important clues regarding the nature of cystic and cavitary lesions in the lung. [ABSTRACT FROM AUTHOR]
- Published
- 2003
26. Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation.
- Author
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Palmas, Angelo, Tefferi, Ayalew, Myers, Jeffrey L., Scott, John P., Swensen, Stephen J., Chen, Michael G., Gastineau, Dennis A., Gertz, Morie A., Inwards, David J., Lacy, Martha Q., and Litzow, Mark R.
- Subjects
- *
LUNG diseases , *BONE marrow transplantation - Abstract
We examined the incidence and clinical outcome of late-onset noninfectious pulmonary complications (LONIPC) in a series of 234 patients who underwent allogeneic bone marrow transplantation at our institution between April 1982 and October 1996. The 179 patients who survived 3 months or more were evaluated. Clinical, radiologic, pulmonary function, and pathologic tests were reviewed to identify 18 patients (10%) who fulfilled the diagnostic criteria of LONIPC. Accordingly, the pulmonary processes included bronchiolitis obliterans (BO, five patients), bronchiolitis obliterans with organizing pneumonia (BOOP, three patients), diffuse alveolar damage (DAD, one patient), lymphocytic interstitial pneumonia (LIP, one patient), and nonclassifiable interstitial pneumonia (NCIP, eight patients). Various methods of enhanced immunosuppressive therapy resulted in marked durable remission in nine patients (50%) (3/3 with BOOP, 3/8 with NCIP, 1/1 with DAD, 1/1 with LIP, 1/5 with BO). The presence of chronic graft-versus-host disease (cGVHD) and prophylaxis for GVHD with cyclosporine and prednisone were the only variables significantly associated with the development of LONIPC (P = 0.0001 and 0.008, respectively). Regardless of histology, a reduction in the forced expiratory volume to < 45% of the predicted range was associated with poor response to treatment. These findings suggest a strong association between cGVHD and LONIPC and that the risk of LONIPC development may be influenced by the particular method of GVHD prophylaxis. Most patients with BOOP or mild airflow limitation at diagnosis achieved durable remissions. [ABSTRACT FROM AUTHOR]
- Published
- 1998
- Full Text
- View/download PDF
27. Computed Tomography Screening for Lung Cancer.
- Author
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Bach, Peter B., Jett, James R., Pastorino, Ugo, Tockman, Melvyn S., Swensen, Stephen J., and Begg, Colin B.
- Subjects
- *
LETTERS to the editor , *LUNG cancer - Abstract
A reply from Drs. Peter B. Bach, James R. Jett and colleagues is presented in response to letters to the editor about their article "Computed tomography screening and lung cancer outcomes."
- Published
- 2007
- Full Text
- View/download PDF
28. Lung cancer screening results: easily misunderstood.
- Author
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Midthun DE, Swensen SJ, Hartman TE, Jett JR, Midthun, David E, Swensen, Stephen J, Hartman, Thomas E, and Jett, James R
- Published
- 2007
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