RESUMEN
We assessed the effect of two different methods of contacting the target population on the rate of participation in a colorectal cancer screening programme. All individuals aged between 50 and 74 years enlisted in one primary health care centre in Barcelona (Spain) were included in a prospective randomized controlled trial. An invitation letter signed by a doctor together with two containers for faecal sample collection were sent by post to subjects in the 'standard' group (n = 1060), while subjects in the 'study' group (direct contact, n = 965) were visited by a trained non-health professional who supplied them with the same documentation as the standard group. The screening test consisted of an immunological method for the detection of faecal blood which does not require any prior specific dietary measures. Specimens were collected on two successive days. A significantly higher participation was observed in the study group (557/965, 57.7%) compared with the standard group (388/1060, 36.5%, P < 0.005). Specimen collection correctness was also higher in the study group (419/557, 75.1%) compared with the standard group (262/388, 67.5%, P < 0.014). There were no differences in terms of either age group or sex for the participation, nor for degree of correctness of specimen collection. Participation and specimen collection can be raised in colorectal cancer screening programmes by means of an invitation made through direct contact by a suitably trained non-health professional.
Asunto(s)
Neoplasias Colorrectales/prevención & control , Necesidades y Demandas de Servicios de Salud , Tamizaje Masivo/métodos , Anciano , Métodos Epidemiológicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , EspañaRESUMEN
OBJECTIVE: To determine wether the physical status (ASA category) and surgical conditions could predict mortality in elderly general surgery patients. PATIENTS AND METHODS: This was a prospective study of patients greater than or equal 85 years of age who underwent elective or emergency surgery under general anesthesia between January 1987 and December 1991. Hospital mortality was defined as death occurring before discharge. Logical regression analysis (Cox's modeling) was used to assess group survival. RESULTS: One hundred and nine patients undergoing 117 operations were enrolled. Major surgery was performed in 70%; 44% were removals of malignant tumors and 84% were under general anesthesia. Hospital deaths occurred in 10%; the only significant predictors were neoplastic disease and emergency status. Mortality was 43% one year after surgery; significant predictors of death were prior physical status, neoplasia and emergency status. CONCLUSIONS: Neoplastic disease, emergency status and poor physical condition are factors that predict mortality in patients 85 or older who undergo general surgery.
Asunto(s)
Procedimientos Quirúrgicos Operativos/mortalidad , Anciano , Anciano de 80 o más Años , Urgencias Médicas , Femenino , Humanos , Tablas de Vida , Masculino , Neoplasias/mortalidad , Neoplasias/cirugía , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Análisis de SupervivenciaRESUMEN
This paper reports two late complications of oesophageal replacement using the reversed gastric tube described by Gavriliu. One patient developed obstruction of the gastric tube and the other a perforation of a diverticulum within the gastric tube, both occurring more than 10 years after the original operation. The occurrence of such complications should be made known to surgeons who are contemplating using this form of oesophageal replacement.