RESUMEN
The sensitivity of the guaiac-impregnated card, hemoccult II, for the detection of colorectal neoplasia was tested in 213 patients undergoing elective colonoscopy over a 10-month period. Contrary to statements in standard texts as to the high sensitivity of guaiac-impregnated cards for the detection of these tumors, our results demonstrate only a 52% sensitivity for colorectal carcinoma and a 23% sensitivity for adenomatous polyps over 1.0 cm in diameter. We compare these results to other studies testing hemoccult sensitivity in the presence of colorectal neoplasia. This relatively low sensitivity rate emphasizes that the use of guaiac-impregnated cards alone does not exclude colorectal carcinoma in any patient.
Asunto(s)
Neoplasias del Colon/diagnóstico , Guayaco , Sangre Oculta , Juego de Reactivos para Diagnóstico , Neoplasias del Recto/diagnóstico , Adulto , Anciano , Colonoscopía , Humanos , Pólipos Intestinales/diagnóstico , Persona de Mediana Edad , ProbabilidadRESUMEN
A prospective, randomized double-blind trial of doxycycline prophylaxis for traveler's diarrhea was conducted on 145 volunteers during a 2.5-day visit to Mexico. Traveler's diarrhea occurred in 15 (21%) of the placebo group and in 3 (4%) of the doxycycline group (p = 0.002). There was no rebound increase in the incidence of acute diarrhea after departure from the high risk area in the doxycycline-treated group. A variety of bacterial pathogens were isolated from individuals symptomatic with traveler's diarrhea. Nausea alone (8%) or nausea with vomiting (4%) occurred in the doxycycline-treated group only and were the only side effects observed (p = 0.003). We conclude that doxycycline is safe and efficacious for the prophylaxis of traveler's diarrhea for short-term exposure in a high risk area.
Asunto(s)
Diarrea/prevención & control , Doxiciclina/uso terapéutico , Infecciones por Escherichia coli/prevención & control , Viaje , Adolescente , Adulto , Método Doble Ciego , Doxiciclina/efectos adversos , Humanos , Masculino , México , Persona de Mediana Edad , Náusea/inducido químicamente , Premedicación , Estudios Prospectivos , Distribución Aleatoria , Factores de Tiempo , Vómitos/inducido químicamenteRESUMEN
Due to the evidence that a splenectomized patient is at increased risk for serious infection, nonoperative management of splenic injury, as well as operations designed to preserve functioning splenic tissue, have been recently reported. Most experience in nonoperative management has been in the pediatric and young-adult age groups. We report a case of delayed rupture of the spleen in a middle-aged patient who was successfully managed nonoperatively and was followed with ultrasonography to resolution.