RESUMO
OBJECTIVE: To show our experience and results in Virtual Colonoscopy (VC). MATERIAL AND METHOD: Five hundred patients with personal or familial history of colorectal carcinoma and/or adenomas, or any kind of coloproctologic symptoms were studied. VCs were practiced using a helical CT scanner (300 patients) and a multislice CT scanner (200 patients) a few hours after Conventional Colonoscopy (CC), considered the gold standard. The patients were evaluated in a prospective blind study, to determine sensitivity and specificity of VC. Findings were classified as: 1) normal studies; 2) studies with pathological findings. This one was subdivided into: 2a) Lesions below 5 mm., 2b) Lesions between 5-9 mm., 2c) Lesions above 9 mm. RESULTS: VC detected 253 normal studies whereas CC only detected 233. The sensitivity and specificity for each subgroup were: 2a) 87.8% and 86.9%; 2b) 95.6% and 91.4%; 2c) 100.0% and 100.0% respectively. CONCLUSION: VC is a feasible and useful method for evaluating the entire colon. It is well tolerated, it has no complications and a high sensitivity and specificity for elevated lesions, especially the ones above or equal to 5 mm.
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Adulto , Pólipos do Colo , Colonoscopia , Neoplasias Colorretais , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Método Simples-CegoRESUMO
OBJECTIVE: To show our experience and results in Virtual Colonoscopy (VC). MATERIAL AND METHOD: Five hundred patients with personal or familial history of colorectal carcinoma and/or adenomas, or any kind of coloproctologic symptoms were studied. VCs were practiced using a helical CT scanner (300 patients) and a multislice CT scanner (200 patients) a few hours after Conventional Colonoscopy (CC), considered the gold standard. The patients were evaluated in a prospective blind study, to determine sensitivity and specificity of VC. Findings were classified as: 1) normal studies; 2) studies with pathological findings. This one was subdivided into: 2a) Lesions below 5 mm., 2b) Lesions between 5-9 mm., 2c) Lesions above 9 mm. RESULTS: VC detected 253 normal studies whereas CC only detected 233. The sensitivity and specificity for each subgroup were: 2a) 87.8% and 86.9%; 2b) 95.6% and 91.4%; 2c) 100.0% and 100.0% respectively. CONCLUSION: VC is a feasible and useful method for evaluating the entire colon. It is well tolerated, it has no complications and a high sensitivity and specificity for elevated lesions, especially the ones above or equal to 5 mm. (AU)
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Adulto , Idoso , Pólipos do Colo/diagnóstico por imagem , Neoplasias Colorretais/diagnóstico por imagem , Colonoscopia/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Método Simples-CegoRESUMO
OBJECTIVE: To show our experience and results in Virtual Colonoscopy (VC). MATERIAL AND METHOD: Five hundred patients with personal or familial history of colorectal carcinoma and/or adenomas, or any kind of coloproctologic symptoms were studied. VCs were practiced using a helical CT scanner (300 patients) and a multislice CT scanner (200 patients) a few hours after Conventional Colonoscopy (CC), considered the gold standard. The patients were evaluated in a prospective blind study, to determine sensitivity and specificity of VC. Findings were classified as: 1) normal studies; 2) studies with pathological findings. This one was subdivided into: 2a) Lesions below 5 mm., 2b) Lesions between 5-9 mm., 2c) Lesions above 9 mm. RESULTS: VC detected 253 normal studies whereas CC only detected 233. The sensitivity and specificity for each subgroup were: 2a) 87.8% and 86.9%; 2b) 95.6% and 91.4%; 2c) 100.0% and 100.0% respectively. CONCLUSION: VC is a feasible and useful method for evaluating the entire colon. It is well tolerated, it has no complications and a high sensitivity and specificity for elevated lesions, especially the ones above or equal to 5 mm.
Assuntos
Pólipos do Colo/diagnóstico por imagem , Colonografia Tomográfica Computadorizada , Neoplasias Colorretais/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Método Simples-CegoRESUMO
OBJECTIVE: To show our experience and results in Virtual Colonoscopy (VC). MATERIAL AND METHOD: Five hundred patients with personal or familial history of colorectal carcinoma and/or adenomas, or any kind of coloproctologic symptoms were studied. VCs were practiced using a helical CT scanner (300 patients) and a multislice CT scanner (200 patients) a few hours after Conventional Colonoscopy (CC), considered the gold standard. The patients were evaluated in a prospective blind study, to determine sensitivity and specificity of VC. Findings were classified as: 1) normal studies; 2) studies with pathological findings. This one was subdivided into: 2a) Lesions below 5 mm., 2b) Lesions between 5-9 mm., 2c) Lesions above 9 mm. RESULTS: VC detected 253 normal studies whereas CC only detected 233. The sensitivity and specificity for each subgroup were: 2a) 87.8
and 86.9
; 2b) 95.6
and 91.4
; 2c) 100.0
and 100.0
respectively. CONCLUSION: VC is a feasible and useful method for evaluating the entire colon. It is well tolerated, it has no complications and a high sensitivity and specificity for elevated lesions, especially the ones above or equal to 5 mm.
Assuntos
Saúde Pública , Opinião Pública , Política Pública , Predomínio Social , Previdência Social , Fatores Socioeconômicos , Chile/etnologia , Educação/economia , Educação/história , Educação/legislação & jurisprudência , Programas Governamentais/economia , Programas Governamentais/educação , Programas Governamentais/história , Programas Governamentais/legislação & jurisprudência , História do Século XX , Sistemas Políticos/história , Saúde Pública/economia , Saúde Pública/educação , Saúde Pública/história , Saúde Pública/legislação & jurisprudência , Opinião Pública/história , Política Pública/economia , Política Pública/história , Política Pública/legislação & jurisprudência , Condições Sociais/economia , Condições Sociais/história , Condições Sociais/legislação & jurisprudência , Previdência Social/economia , Previdência Social/história , Previdência Social/legislação & jurisprudência , Seguridade Social/economia , Seguridade Social/etnologia , Seguridade Social/história , Seguridade Social/legislação & jurisprudência , Seguridade Social/psicologiaRESUMO
Con el objeto de mostrar una nueva modalidad diagnóstica no invasiva en el diagnóstico precoz del cáncer colorrectal se analizaron 46 pacientes seleccionados sobre la base del cuadro clínico y/o los antecedentes de enfermedad colorrectal o poliposis familiar. Los hallazgos obtenidos por colonoscopía virtual los dividimos en siete grupos: lesión polipoidea única (9 pacientes), lesiones polipoideas asociadas (11); estenosis tumorales sin lesión sincrónica (3); estenosis tumorales con lesión sincrónica (6); estenosis no tumorales (4); estudios normales (2); pacientes excluidos por mala preparación. Concluimos que la colonoscopia virtual es una alternativa válida en el screening de la patología colorrectal, presentando algunas ventajas sobre los estudios habituales, ya que no es invasivo, no requiere sedación y permite la estadificación de la enfermedad neoplásica
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Colonoscopia , Neoplasias Colorretais/diagnóstico , Pólipos do Colo/diagnóstico , Estadiamento de Neoplasias , Peneiramento de Líquidos , Tomografia Computadorizada por Raios X/métodosRESUMO
Con el objeto de mostrar una nueva modalidad diagnóstica no invasiva en el diagnóstico precoz del cáncer colorrectal se analizaron 46 pacientes seleccionados sobre la base del cuadro clínico y/o los antecedentes de enfermedad colorrectal o poliposis familiar. Los hallazgos obtenidos por colonoscopía virtual los dividimos en siete grupos: lesión polipoidea única (9 pacientes), lesiones polipoideas asociadas (11); estenosis tumorales sin lesión sincrónica (3); estenosis tumorales con lesión sincrónica (6); estenosis no tumorales (4); estudios normales (2); pacientes excluidos por mala preparación. Concluimos que la colonoscopia virtual es una alternativa válida en el screening de la patología colorrectal, presentando algunas ventajas sobre los estudios habituales, ya que no es invasivo, no requiere sedación y permite la estadificación de la enfermedad neoplásica (AU)
Assuntos
Estudo Comparativo , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias Colorretais/diagnóstico , Colonoscopia/métodos , Pólipos do Colo/diagnóstico , Estadiamento de Neoplasias , Tomografia Computadorizada por Raios X/métodos , Programas de RastreamentoRESUMO
BACKGROUND: The long-term efficacy and tolerability of the antidepressant reboxetine, a unique selective norepinephrine reuptake inhibitor (selective NRI), were assessed in an international study. METHOD: Two hundred eighty-three patients with recurrent DSM-III-R major depression who responded to 6 weeks of reboxetine treatment (> or =50% decrease in Hamilton Rating Scale for Depression [HAM-D] total score) were randomly assigned to receive reboxetine or placebo for 46 weeks in a double-blind phase. Relapse (> or =50% increase in HAM-D total score and/or a HAM-D total score > or =18) rate was the principal assessment criterion and included patients who experienced relapse or recurrence. Only patients who remained relapse-free at the end of the first 6-month treatment period were included in the relapse rate assessment at the end of the second 6-month treatment period. RESULTS: Reboxetine was associated with a markedly lower relapse rate than placebo (22% vs. 56%; p<.001) and a greater cumulative probability of a maintained response (p = .0001) during long-term treatment. Patients in remission (HAM-D total score < or =10) at the time of random assignment were less likely to relapse (16% reboxetine, 48% placebo; p<.001). The proportion of patients who were relapse-free and therefore remained in the study was significantly (p< or =.001) higher among those on reboxetine treatment than on placebo at the end of the first (61% vs. 40%) and second (88% vs. 59%) 6 months of treatment. Additional efficacy measures supported these findings. The incidence of adverse events with reboxetine was low and comparable with that for placebo. Discontinuation due to adverse events occurred infrequently. CONCLUSION: Reboxetine treatment over 1 year is more effective than placebo in the prevention of relapse in patients with recurrent depression. The low relapse rates at the end of the second 6 months of treatment further suggest that reboxetine effectively prevents recurrence of depressive symptoms following episode resolution. Reboxetine is well tolerated in long-term treatment of depression, a finding that bodes well for long-term patient compliance.