Asunto(s)
Bronquitis/inducido químicamente , Enfermedad de Crohn/tratamiento farmacológico , Infliximab/efectos adversos , Infliximab/uso terapéutico , Infecciones Oportunistas/inducido químicamente , Infecciones Estafilocócicas/inducido químicamente , Administración Oral , Adolescente , Bronquiectasia/diagnóstico , Bronquiectasia/tratamiento farmacológico , Bronquitis/diagnóstico , Bronquitis/tratamiento farmacológico , Broncoscopía , Floxacilina/uso terapéutico , Hamartoma/diagnóstico , Humanos , Infusiones Intravenosas , Imagen por Resonancia Magnética , Masculino , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/tratamiento farmacológico , Nódulo Pulmonar Solitario/diagnóstico , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológico , Tomografía Computarizada por Rayos XAsunto(s)
Pleura/cirugía , Cavidad Pleural/cirugía , Punciones/métodos , Anestesia Local , Contraindicaciones , Empiema Pleural/diagnóstico , Empiema Pleural/diagnóstico por imagen , Empiema Pleural/cirugía , Humanos , Consentimiento Informado , Pleura/diagnóstico por imagen , Cavidad Pleural/diagnóstico por imagen , Derrame Pleural/diagnóstico , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/cirugía , Cuidados Posoperatorios , Cuidados Preoperatorios , Punciones/normas , UltrasonografíaRESUMEN
BACKGROUND: : FDG-PET is a powerful tool for the diagnostic workup of patients with lung cancer. A reduced sensitivity of FDG-PET for the evaluation of lung lesions was reported for bronchioloalveolar carcinoma (BAC). No literature exists about the diagnostic efficacy of FDG-PET in the staging of BAC. METHODS: : Out of a series of subsequent 630 untreated patients with the final diagnosis of lung cancer, who underwent FDG-PET, all patients with BAC were evaluated with respect to tumour detection, N-staging, and M-staging. RESULTS: : 35 patients (5.6 %) had BAC, 22 in a localized form (8 x pT1, 14 x pT2), 13 in a disseminated stage. FDG-PET correctly identified 19/22 cases with localized forms. Two of the missed one were classified as pT1. All disseminated forms of BAC were detected. Standardized uptake values (SUV) ranged from 0.9 to 23.3 (mean +/- SD: 11.6 +/- 5.1). Accuracy of N-staging was comparable to known results in lung cancer (FDG-PET 80 %, CT 64 %). With respect to M-staging, sensitivity of FDG-PET was as follows: M1(HEP): 2/3 (67 %), M1(PUL): 7/8 (88 %), M1(OSS): 1/1 (100 %). CONCLUSIONS: : With some limitations in small localized tumours FDG-PET can detect and stage BAC with an accuracy which is identical to that for other histological types of non-small cell lung cancer.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico por imagen , Tomografía Computarizada de Emisión , Carcinoma de Pulmón de Células no Pequeñas/patología , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Radiofármacos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos XRESUMEN
The aim of the present investigation was to evaluate the diagnostic accuracy of positron emission tomography with 18-fluoro-2-deoxyglucose (FDG-PET) in the detection of recurrent lung cancer. PET was performed using an ECAT ART scanner (Siemens CTI) after i.v. injection of 220 +/- 50 MBq 18FDG. PET data were analysed by visual interpretation of coronal, sagittal and transversal slices. PET scans were interpreted independently by two experienced nuclear medicine physicians without prior knowledge of the results of other imaging studies or clinical data. 40 patients (= 41 cases) who had undergone primarily curative tumour treatment, were evaluated. In 29 of 35 cases with recurrent tumour, diagnosis was verified by pathologic means. FDG-PET correctly identified tumour recurrence in 34/35 cases. In 5/6 cases without prevent tumour recurrence PET gave true negative results. The overall accuracy of FDG-PET was 39/41 = 95% (95%-confidence interval 83-99%). FDG-PET shows high diagnostic accuracy in detecting recurrent lung cancer in patients with prior curative tumour treatment, but cannot substitute the need for pathological diagnosis.
Asunto(s)
Carcinoma Broncogénico/diagnóstico por imagen , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Carcinoma de Células Pequeñas/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares/diagnóstico por imagen , Recurrencia Local de Neoplasia/diagnóstico por imagen , Tomografía Computarizada de Emisión , Anciano , Carcinoma Broncogénico/patología , Carcinoma Broncogénico/terapia , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/terapia , Carcinoma de Células Pequeñas/patología , Carcinoma de Células Pequeñas/terapia , Terapia Combinada , Femenino , Humanos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/terapia , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/terapia , Estadificación de NeoplasiasRESUMEN
The value of FDG-PET in oncology is currently investigated in clinical studies. There is only limited information on the usefulness of FDG-PET in the evaluation of distant metastases of lung cancer. The purpose of the present prospective investigation was to determine the diagnostic accuracy of FDG-PET in the detection of brain metastases of lung cancer. After intravenous injection of 220 +/- 50 MBq F-18-deoxyglucose PET acquisition was carried out using an ECAT ART scanner (CTI Siemens). Images were reconstructed using a filtered backprojection with a Hanning filter. PET data were analyzed by visual interpretation of coronal, sagittal and transversal slices. PET scans were interpreted by two experienced nuclear medicine physicians without prior knowledge of the results of other imaging studies or clinical data. Between March 1997 and July 1998 whole-body PET was performed in 417 patients with suspected lung cancer. 402 patients were used for statistical analysis. Based on conventional brain imaging with CT (occasionally MRI), brain metastases were suspected in 17 patients (prevalence 4.2%). For FDG-PET alone, sensitivity was 82% (14/17) and specificity 38% (14/37). Therefore, diagnostic accuracy of FDG-PET in detection of brain metastases was 93.5%. The low specificity of FDG-PET can be explained by reduced tracer uptake mainly due to brain infarction or vascular encephalopathy in this group of elderly patients. Our results indicate that due to its low specificity FDG-PET is not useful for the evaluation of brain metastases in the primary staging of patients with lung cancer.
Asunto(s)
Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/secundario , Fluorodesoxiglucosa F18/uso terapéutico , Neoplasias Pulmonares/diagnóstico por imagen , Tomografía Computarizada de Emisión/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
This project represents an effort to incorporate a feminist perspective into research on mammography screening. The purpose of this study was to assess women's attitudes toward four advertisements designed to encourage mammography screening. The goal was to create awareness about women's attitudes toward mammography advertisements in order to encourage the development of more effective and responsive motivational materials. The results indicated that each ad communicated different messages about the seriousness of breast cancer and the efficacy of mammography in detecting early breast cancer. Each ad also affected women differently regarding their feelings of control over breast cancer, their perceived loss of sex appeal resulting from a breast cancer diagnosis, and their general fear of breast cancer.
Asunto(s)
Publicidad/normas , Actitud Frente a la Salud , Mamografía/psicología , Medios de Comunicación de Masas/normas , Salud de la Mujer , Adulto , Anciano , Femenino , Feminismo , Humanos , Persona de Mediana Edad , Investigación Metodológica en EnfermeríaRESUMEN
Zardaverine is a selective inhibitor of phosphodiesterase (PDE) III and IV isozymes. It has been shown to exert potent bronchodilator effects in animals. In order to study the efficacy and safety in man, a phase II clinical trial in 10 patients with partially reversible chronic airflow obstruction was carried out. The trial was designed as a double-blind, randomized, five-period change-over study. Zardaverine (at single doses of 1.5 mg, 3.0 mg, or 6.0 mg), salbutamol (0.3 mg) and placebo were administered by metered dose inhaler on separate days. As evaluated by spirometry over a time period of 4 h, salbutamol induced a significant bronchodilatation. In contrast, zardaverine did not improve airway function in these patients. Unwanted effects of the study medication were not observed.