RESUMO
BACKGROUND: In relation to the number of new cases diagnosed, gastric cancer is the fourth most common cancer worldwide, and the second cause of cancer death. The development of multidetector tomography has improved the preoperative staging of gastric cancer. AIM: To correlate preoperative tomographic studies with the definitive pathologic results according to the TNM staging system. METHODS: A retrospective, cross-sectional study within the time frame of January 2009 to December 2013 was conducted that included the case records of 67 patients. They all had upper endoscopy and preoperative multidetector tomography examinations, underwent surgical resection, and had the corresponding histopathology study. Statistical analysis was carried out with the SPSS version 15.0 software and the sensitivity and specificity calculations were made using the Excel 2011 program for Mac. RESULTS: The majority of the patients included in the case series had clinical stage iii and iv disease. When compared with the histopathologic result, the overall accuracy of multidetector CT was 83% (T0 96%, T1 94%, T2 93%, T3 67%, and T4 67%) for tumor size (T) and was 70% (N0 72%, N1 73%, N2 70%, and N3 66%) for lymph node involvement (N). Overall sensitivity was 48% (T0 100%, T1 0%, T2 33%, T3 44%, and T4 65%) for T and was 41% (N0 58%, N1 56%, N2 15%, and N3 35%) for N. A strong association between the multidetector CT results and the pathology results was demonstrated through the Spearman's correlation, especially in T4 and N3. CONCLUSIONS: Multidetector computed tomography showed greater congruency in detecting stages T4, N0, and N3 in gastric cancer, when compared with the definitive histopathologic results.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Tomografia Computadorizada Multidetectores , Cuidados Pré-Operatórios , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Hospitais Militares , Humanos , Masculino , México , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Sensibilidade e Especificidade , Neoplasias Gástricas/cirurgiaRESUMO
The present study is a non-inferiority study based on a descriptive and comparative case series for comparison of generic vs. original intravenous antimicrobials in septic oncology patients at an oncology private ICU. 1906 cancer patients admitted to Arturo Lopez Perez Foundation, Chile, were included in this study. After recruitment, a first retrospective group of 206 septic cancer patients recorded from 1st January, 2008 until July 14th, 2010, treated with original antibiotics (cefoperazone-sulbactam, imipenem-cilastatin, piperacillin-tazobactam) were included for analyses and a second prospective group of 143 septic cancer patients recorded from July 15th, 2010 until January 02, 2013, treated with the same but generic antibiotics were also included for comparisons. The trial protocol was developed in accordance with Helsinki and Good Clinical Practices recommendations. The results of this study showed no significant differences between the 2 groups in days of treatment, rate of success and lab test determinations (white cell count, PCR and procalcitonin), with lower, but not significant, total bed days and CPU bed days for generic antibiotics. Therefore, we conclude that the safety and efficacy of the generic antibiotics cefactam®, imipen® and Piperazam® are not inferior to original antibiotics for the treatment of severe sepsis in hospitalised patients at the Arturo Lopez Perez Foundation.
Assuntos
Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Cefoperazona/uso terapêutico , Cilastatina/uso terapêutico , Imipenem/uso terapêutico , Serviço Hospitalar de Oncologia , Ácido Penicilânico/análogos & derivados , Sepse/tratamento farmacológico , Sulbactam/uso terapêutico , Administração Intravenosa , Antibacterianos/administração & dosagem , Cefoperazona/efeitos adversos , Cilastatina/efeitos adversos , Combinação Imipenem e Cilastatina , Combinação de Medicamentos , Medicamentos Genéricos/efeitos adversos , Medicamentos Genéricos/uso terapêutico , Feminino , Humanos , Imipenem/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ácido Penicilânico/efeitos adversos , Ácido Penicilânico/uso terapêutico , Projetos Piloto , Piperacilina/efeitos adversos , Piperacilina/uso terapêutico , Combinação Piperacilina e Tazobactam , Estudos Prospectivos , Estudos Retrospectivos , Sulbactam/efeitos adversos , Resultado do TratamentoRESUMO
Antecedentes. En 2003 se reportó incidencia de 762 casos de neumoconiosis y 3686 casos de enfermedad respiratoria crónica en Colombia.Objetivo. Evaluar la utilidad de las técnicas de espirometría y oximetría para determinar la prevalencia de disfuncionalidad respiratoria en trabajadores de minas de carbón de PaipaBoyacá y establecer posibles factores asociados, como edad y tiempo de exposición, para proponer medidas preventivas de salud ocupacional.Material y métodos. Estudio de corte transversal, observacional, analítico. Mediante instrumento previamente diseñado se encuestó a 410, trabajadores de las minas de carbón. Se evaluaron aspectos generales del trabajo, antecedentes de salud y parámetros de función respiratoria por espirometría y oximetría.Resultados. Grupo de sujetos jóvenes: promedio de edad 35,07 años (SD=11,75). Promedio de exposición 12,8 años (SD=11,8). Alta prevalencia de síntomas respiratorios: tos (42,7 por ciento); expectoración (31,46 por ciento); disnea (48,8 por ciento); dolor torácico (19,75 por ciento). En 26,1 por ciento alteración funcional respiratoria y en 3,99 por ciento, hipoxemia. Tiempo de exposición superior a cinco años se asoció con alteración respiratoria (RP=1,75) y con hipoxemia (RP= 9,30). Igualmente edad superior a 40 años se asoció con alteración espirométrica (RP=1,91) e hipoxemia (RP=3,07). Conclusiones. Actividad de alto riesgo. Altas prevalencias de sintomatología sugestiva de neumoconiosis y enfermedad pulmonar crónica en progreso. Se encuentran elevadas prevalencia de anormalidad del patrón respiratorio y de hipoxemia, lo cual sugiere que estas estimaciones podrían ser predictores del desarrollo de enfermedad pulmonar crónica de origen laboral.