7 research outputs found
Prediction of the response of chronic hepatitis C to interferon alfa: a statistical analysis of pretreatment variables
Pretreatment variables that could predict the response of chronic hepatitis C to interferon alfa treatment have not been fully assessed. Eighteen baseline variables were evaluated in a series of 100 consecutive patients treated with a 12 month course of interferon alfa. For the purposes of this study, response was defined as the return to normal of aminotransferase activities before the third month of treatment. Seventy per cent of the patients responded to treatment. Six variables were associated with an increased likelihood of response assessed by univariate analysis. With stepwise multiple regression analysis assessment, however, only three variables remained independently predictive of response: low gamma glutamyltransferase (gamma GT) activities (p 0.66 mu kat/l (n = 45) (p = 0.048). Response was attained in 75% of non-obese patients (n = 80), compared with only 50% of obese patients (n = 20) (p = 0.03). Finally, 80% of patients without cirrhosis (n = 76) responded, while among those with cirrhosis (n = 24) the response rate was only 37% (p 40 years old, and with gamma GT activities >0.66 mu kat/l responded to interferon alfa (p<0.001). Those findings may be useful when evaluating interferon alfa trials and it is suggested that this treatment should be applied early in the course of chronic hepatitis C
Técnicas terapéuticas endovasculares
Percutaneous and endovascular techniques have
shown their efficacy in the treatment of a great variety
of pathologies. The advances in diagnostic imaging as
well as the development of new materials have made it
possible to carry out new procedures that were
unthinkable not many years ago. The irruption of this
new form of treating patients has had, is having, and
will have a clear impact on the multidisciplinary
approach to numerous diseases
Neumatosis intestinal y gas portomesentérico: a propósito de un caso
La neumatosis intestinal (presencia de gas en el interior de la pared
intestinal y en el complejo venoso portomesentérico) es una situación
clínica poco frecuente que ha sido característicamente relacionada con
la isquemia intestinal y con un desenlace fatal. Existen otras causas que
pueden justifi
car estos hallazgos y cuya repercusión para el paciente no
es inevitablemente trágica. Los avances recientes en técnicas de imagen,
sobre todo en tomografía computarizada multicorte (TCMC), permiten un
diagnóstico preciso fi
able y precoz de estos hallazgos. En este artículo,
repasamos las manifestaciones radiológicas de la neumatosis intestinal
en TC así como las distintas causas relacionadas con esta entidad, en
relación con los hallazgos presentes en un paciente diagnosticado de
carcinoma de esófago y en tratamiento quimioterápico. INGLÉS: Intestinal pneumatosis (presence of gas in the intestinal wall and in the portomeseteric veins) is an infrequent clinical situation that has been associated with extended bowel necrosis and fatal outcome. However, there are other reasons that can justify these findings without such an outcome. Recent advances in diagnostic imaging techniques, especially multislice computerized tomography (MSCT), have allowed precise and quick diagnosis of these entities. In this article, we review the MSCT radiological manifestations of intestinal pneumatosis, as well as the different diagnoses related with the findings observed in a patient diagnosed with esophageal carcinoma under chemotherapy treatment
Early lung cancer detection using spiral computed tomography and positron emission tomography
RATIONALE:
Lung cancer screening using computed tomography (CT) is effective in detecting lung cancer in early stages. Concerns regarding false-positive rates and unnecessary invasive procedures have been raised.
OBJECTIVE:
To study the efficiency of a lung cancer protocol using spiral CT and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET).
METHODS:
High-risk individuals underwent screening with annual spiral CTs. Follow-up CTs were done for noncalcified nodules of 5 mm or greater, and FDG-PET was done for nodules 10 mm or larger or smaller (> 7 mm), growing nodules.
RESULTS:
A total of 911 individuals completed a baseline CT study and 424 had at least one annual follow-up study. Of the former, 14% had noncalcified nodules of 5 mm or larger, and 3.6% had nodules of 10 mm or larger. Eleven non-small cell lung cancers (NSCLC) and one small cell lung cancer (SCLC) were diagnosed in the baseline study (prevalence rate, 1.32%), and two NSCLCs in the annual study (incidence rate, 0.47%). All NSCLCs (92% of prevalence cancers) were diagnosed in stage I (12 stage IA, 1 stage IB). FDG-PET was helpful for the correct diagnosis in 19 of 25 indeterminate nodules. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET for the diagnosis of malignancy were 69, 91, 90, and 71%, respectively. However, the sensitivity and negative predictive value of the screening algorithm, which included a 3-month follow-up CT for nodules with a negative FDG-PET, was 100%.
CONCLUSION:
A protocol for early lung cancer detection using spiral CT and FDG-PET is useful and may minimize unnecessary invasive procedures for benign lesions
Neumatosis intestinal y gas portomesentérico: a propósito de un caso
La neumatosis intestinal (presencia de gas en el interior de la pared
intestinal y en el complejo venoso portomesentérico) es una situación
clínica poco frecuente que ha sido característicamente relacionada con
la isquemia intestinal y con un desenlace fatal. Existen otras causas que
pueden justifi
car estos hallazgos y cuya repercusión para el paciente no
es inevitablemente trágica. Los avances recientes en técnicas de imagen,
sobre todo en tomografía computarizada multicorte (TCMC), permiten un
diagnóstico preciso fi
able y precoz de estos hallazgos. En este artículo,
repasamos las manifestaciones radiológicas de la neumatosis intestinal
en TC así como las distintas causas relacionadas con esta entidad, en
relación con los hallazgos presentes en un paciente diagnosticado de
carcinoma de esófago y en tratamiento quimioterápico. INGLÉS: Intestinal pneumatosis (presence of gas in the intestinal wall and in the portomeseteric veins) is an infrequent clinical situation that has been associated with extended bowel necrosis and fatal outcome. However, there are other reasons that can justify these findings without such an outcome. Recent advances in diagnostic imaging techniques, especially multislice computerized tomography (MSCT), have allowed precise and quick diagnosis of these entities. In this article, we review the MSCT radiological manifestations of intestinal pneumatosis, as well as the different diagnoses related with the findings observed in a patient diagnosed with esophageal carcinoma under chemotherapy treatment
Early lung cancer detection using spiral computed tomography and positron emission tomography
RATIONALE:
Lung cancer screening using computed tomography (CT) is effective in detecting lung cancer in early stages. Concerns regarding false-positive rates and unnecessary invasive procedures have been raised.
OBJECTIVE:
To study the efficiency of a lung cancer protocol using spiral CT and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET).
METHODS:
High-risk individuals underwent screening with annual spiral CTs. Follow-up CTs were done for noncalcified nodules of 5 mm or greater, and FDG-PET was done for nodules 10 mm or larger or smaller (> 7 mm), growing nodules.
RESULTS:
A total of 911 individuals completed a baseline CT study and 424 had at least one annual follow-up study. Of the former, 14% had noncalcified nodules of 5 mm or larger, and 3.6% had nodules of 10 mm or larger. Eleven non-small cell lung cancers (NSCLC) and one small cell lung cancer (SCLC) were diagnosed in the baseline study (prevalence rate, 1.32%), and two NSCLCs in the annual study (incidence rate, 0.47%). All NSCLCs (92% of prevalence cancers) were diagnosed in stage I (12 stage IA, 1 stage IB). FDG-PET was helpful for the correct diagnosis in 19 of 25 indeterminate nodules. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET for the diagnosis of malignancy were 69, 91, 90, and 71%, respectively. However, the sensitivity and negative predictive value of the screening algorithm, which included a 3-month follow-up CT for nodules with a negative FDG-PET, was 100%.
CONCLUSION:
A protocol for early lung cancer detection using spiral CT and FDG-PET is useful and may minimize unnecessary invasive procedures for benign lesions