RESUMEN
To better understand technology diffusion in an ambulatory care setting, we analyzed adult outpatients' use of magnetic resonance (MR) and computed tomography (CT) imaging in a group-model HMO between 1986 and 1989. The use of MR, but not CT, increased at a rapid pace with only a small proportion of the scans being accounted for by primary care physicians.
Asunto(s)
Difusión de Innovaciones , Sistemas Prepagos de Salud/estadística & datos numéricos , Imagen por Resonancia Magnética/estadística & datos numéricos , Adulto , Anciano , District of Columbia , Investigación sobre Servicios de Salud , Hospitales Universitarios , Humanos , Imagen por Resonancia Magnética/economía , Auditoría Médica , Persona de Mediana Edad , Atención Primaria de Salud/tendencias , Tomografía Computarizada por Rayos X/economía , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Estados UnidosRESUMEN
Chylothorax is an unusual complication of various malignant neoplasms, generally lymphomas. The few reported cases of chylothorax with gastric and other abdominal malignancies have involved large abdominal masses with prominent adenopathy and chylous ascites. We describe a patient in whom chylothorax was the presenting manifestation of an adenocarcinoma with probable gastric primary, developing prior to any clinical or radiologic evidence of tumor.