ABSTRACT
Herein, we discussed a case of an otherwise healthy man who presented with progressive gait imbalance and ataxia, found to have small cell lung cancer. Based upon our clinical findings and laboratory data, a diagnosis of paraneoplastic cerebellar degeneration was made. Paraneoplastic neurological syndromes (PNS) are relatively rare but diverse and always should be considered in differentials. A diagnostic algorithm along with appropriate work up is discussed here.
ABSTRACT
OBJECTIVES: Disease surveillance by clinicians is critical to public health activities, yet studies have demonstrated significant underreporting of reportable diseases by clinicians. We sought to determine whether an intervention utilizing electronic media increases public health reporting by clinicians. METHODS: A nonrandomized, controlled design with 24-week baseline and intervention outcome periods was used. Five intervention hospitals in the county of Philadelphia received a three-component intervention that included e-mail memoranda, a Web site, and a handheld computer program. Intervention components provided education and information to assist with reporting. Control hospitals comprised all remaining hospitals in the county. RESULTS: E-mails were sent to more than 16500 clinicians and administrative personnel at five hospitals on each of three occasions. The Web site received 866 visits, and the handheld computer program was downloaded 130 times. Intervention hospitals had a mean increase of 5.6 reports, whereas control hospitals had a mean decrease of 3.0 reports (P = .02). CONCLUSIONS: The electronic information-based intervention led to a significant increase in clinician reporting of reportable diseases. Considering the ease and low cost of implementing such programs, they are an attractive method for increasing clinician reporting of public health conditions.
