Water enema computed tomography (WE-CT) in the local staging of low colorectal neoplasms: comparison with transrectal ultrasound

BACKGROUND: To determine the accuracy of computed tomography performed with a water enema application (WE-CT) in the local staging of low colorectal neoplasms and to compare the results with those of transrectal ultrasonography (TRUS). METHODS: Forty patients with low colorectal tumors were evaluated prospectively by CT with the simultaneous administration of a lukewarm rectal enema (0.5-1.5 L). Thin slices (5 mm) and intravenous application of iodinated contrast media were routinely used. TRUS was performed in 18 patients. Tumor size, location, and staging according to the TNM classification of the UICC were registered. Tumors were classified as or 5 mm in diameter was seen (reading A); N+ if at least one peritumoral node > or = 5 mm or three peritumoral nodes < 5 mm were identified (reading B). RESULTS: For the tumor staging, WE-CT showed a sensitivity of 90%, a specificity of 73%, a positive predictive value (PPV) of 90%, a negative predictive value (NPV) of 73%, and an accuracy of 85%. For TRUS, the results were sensitivity of 73%, specificity of 29%, PPV of 62%, NPV of 40%, and an accuracy of 39%. Concerning nodal staging with WE-CT, results were superior when reading A was used: sensitivity = 84%, specificity = 83%, PPV = 73%, NPV = 91%, and accuracy = 84%. TRUS showed a sensitivity of 29%, specificity of 100%, PPV of 100%, NPV of 67%, and an accuracy of 71%. CONCLUSION: WE-CT is a reliable technique for the local staging of low colorectal tumors that can be superior to TRUS. For diagnosis of peritumoral metastatic lymph nodes on WE-CT, the 5-mm diameter cutoff value is the most appropriate size criterion

Renal Artery Angioplasty

Efectuámos angioplastia transiuminal percutânea (ATP) da artéria renal em 59 doentes hipertensos e houve benefício inicial na tensão arterial em 91,5% e tardio em 79,6%. Obtivemos melhores resultados nas lesões unilaterais (81,4%) do que nas bilaterais (72,7%); nas lesões fora do ostium (82,5%) do que nas do ostium (7 1,4%); nas lesões de origem fibromuscular (88,9%) do que nas de origem aterosclerótica(75%); e nos doentes com idade igual ou inferior a 55 anos (84,8%) do que em doentes com idade superior (71,4%). Estas diferenças não foram contudo significativas. Os bons resultados da ATP da artéria renal na hipertensão renovascular levam-nos a considerar esta forma de intervenção como uma alternativa do seu tratamento

Impacto de un programa intervención em alunos del segundo ciclo

O objetivo do presente estudo consistiuem avaliar um programa de intervenção junto a alunos do 2º ciclo de escolaridade nas seguintes dimensões: tomada de decisão, conhecimentos sobre sexualidade, competências sociais, assertividade e autoconceito. Metodologia: Participaram 145 alunos, distribuídos pelos grupos controle e experimental. Os instrumentos utilizados foram: TCU Decision-Making; Questionário de Conhecimentos sobre Sexualidade; Assertion Self-Statement Test- Revised; Questionário de Competências Sociais; Piers-Harris Children’s Self-Concept Scale. Os resultados revelaram diferenças no pós-teste entre os grupos ao nível da sexualidade. Verificaram-se diferenças do pré-teste para o pós-teste no grupo experimental nos níveis da sexualidade, da assertividade e das competências sociais. No grupo experimental encontraram-se associações positivas entre tomada de decisão, competências sociais e assertividade, bem como entre sexualidade, competências sociais e autoconceito, no pós-teste. Os preditores da assertividade no pós-teste foram tomada de decisão, sexualidade e competências sociais. Como conclusão, os resultados enfatizam a importância de intervenção junto a adolescentes, particularmente na tomada de decisão, na sexualidade e nas competências sociais. Palavras-chave: Habilidades sociais, sexualidade, autoconceito.In this study we evaluate an intervention program in the following dimensions: Decision Making, Knowledge on Sexuality, Social Skills, Assertiveness and Self-Concept with students in 5th and 6th grade. Methodology: 145 students participated in the study divided by control and experimental group. The instruments used were: Decision-Making TCU, Knowledge on Sexuality Questionnaire; Assertion Self-Statement Test-Revised;Social Skills Questionnaire, and Piers-Harris Children's Self- Concept Scale. The results indicate differences at post-test between the groups on knowledge regarding sexuality. There were also differences from pre-test to post-test in the experimental group on knowledge on sexuality, assertiveness and social skills. Positive associations among decision making, social skills and assertiveness were found as well as among knowledge on sexuality, social skills and self-concept, in the experimental group, in the pos-test. Finally, the predictors of assertiveness regarding health behaviors, in the pos-test were: decision making, knowledge regarding sexuality and social skills. The results emphasize the importance of intervention for adolescents in terms of health promotion particularly in decision making, sexuality and social skills.El objetivo del presente estudio fue evaluar un programa de intervención con alumnos del 2º ciclo de escolaridad en las siguientes dimensiones: Toma de Decisión, Conocimientos sobre Sexualidad, Habilidades Sociales, Asertividad y Autoconcepto. Metodología: Participaron 145 alumnos, distribuidos en grupo control y experimental. Los instrumentos utilizados fueron: TCU Decision-Making; Cuestionario de Conocimientos sobre Sexualidad; AssertionSelf-Statement Test-Revised; Cuestionario de Habilidades Sociais; Piers-Harris Children'sSelf-Concept Scale. Los resultados mostraron diferencias en el post-test entre los grupos en cuanto a la sexualidad. Se verificaron diferencias del pre-test para el post-teste en el grupo experimental, cuanto a sexualidad, asertividad y habilidades sociales. Se encontraron asociaciones positivas entre toma de decisión, habilidades sociales y asertividad, así como entre sexualidad,habilidades sociales yautoconcepto, en el post-test en el grupo experimental. Los predictores de la asertividad en el post-test fueron toma de decisión, sexualidad y habilidades sociales. Los resultados destacan la importancia de la intervención con adolescentes particularmente en la toma de decisiones, sexualidad y habilidades sociales.(undefined

Induced pneumoperitoneum in CT evaluation of peritoneal carcinomatosis

BACKGROUND: Imaging of peritoneal carcinomatosis is a well-known problem even for technologies as recent as computed tomography (CT). The purpose of this study was to evaluate whether CT performed after induced pneumoperitoneum (CT-PP) could have a higher sensitivity in the detection of peritoneal implants over conventional CT. METHODS: Five patients with known ovarian malignancies underwent standard CT and CT-PP. Exploratory laparotomy was performed with a maximum interval of 7 days from the last imaging procedure. Results were prospectively compared with surgical findings on a compartment to compartment basis. RESULTS: CT-PP was well-tolerated with no serious adverse reactions registered. The anterior and visceral peritoneum, the paracolic gutters and subphrenic areas were particularly well depicted but not the pelvis which was poorly evaluated in all cases. CT-PP detected all the three cases where peritoneal carcinomatosis was present even when metastatic nodules were smaller than 2 mm; it also showed intraabdominal adhesions in two patients, an important finding that precludes the use of intraperitoneal chemotherapy. CONCLUSIONS: With CT-PP there seems to be a reduction in the threshold of detectability of peritoneal implants. The direct demonstration of intraperitoneal adhesions is an important secondary finding. Disadvantages of CT-PP are (1) it is a time-consuming method and (2) it does not evaluate all the peritoneal recesses potentially involved in peritoneal carcinomatosis

Achados audiológicos em crianças com fenilcetonúria Audiologic findings in children with phenylketonuria

OBJETIVO: Investigar a existência de alterações na audição de crianças com fenilcetonúria diagnosticadas e tratadas precocemente e comparar os resultados com os encontrados nas avaliações auditivas de crianças normais de mesma idade. MÉTODOS: Foram realizadas imitanciometria e audiometria tonal e vocal em 63 crianças, sendo 30 no grupo controle, com média de idade de 8,1 anos, e 33 com fenilcetonúria no grupo de estudo, com média de idade de 7,7 anos. O grupo de estudo foi subdividido em 15 crianças com controle adequado da dieta e 18 crianças com controle inadequado da dieta, com médias de idade 8,1 e 7,2, respectivamente. A análise estatística utilizou o Teste t ou ANOVA. RESULTADOS: A audiometria revelou 83,3% de crianças com audição normal no grupo controle e 16,7% de perdas auditivas condutivas uni ou bilaterais. No grupo com fenilcetonúria, 66,7% das crianças apresentaram audição normal e 33,3% com perdas auditivas condutivas. Na imitanciometria, observou-se curvas normais em 91,7% das crianças do grupo controle e em 72,7% das crianças do grupo com fenilcetonúria. Houve diferença na comparação entre grupos para limiares aéreos, reflexos estapedianos, limiares de recepção da fala e índice de reconhecimento de fala. Não foi observada diferença entre os resultados das avaliações auditivas de crianças fenilcetonúricas com dieta adequada e inadequada. CONCLUSÃO: As crianças com fenilcetonúria diagnosticadas e tratadas precocemente apresentaram piores limiares de audibilidade por via aérea, limiares de recepção de fala e índice de reconhecimento de fala evidenciados à audiometria tonal e vocal, quando comparadas com crianças normais.<br>PURPOSE: To investigate the existence of hearing impairments in infants with phenylketonuria with early diagnose and treatment, and to compare the audiological findings with those of their normal peers. METHODS: Vocal and pure-tone audiometry and acoustic immitance tests were conducted in 63 children, 30 from a control group, with mean age of 8.1 years, and 33 from a study group, with phenylketonuria and mean age of 7.7 years. The study group was subdivided according to diet control: 15 subjects had adequate (mean age of 8.1 years) and 18 had inadequate diet control (mean age 7.2 years). Statistical analysis used t-test or ANOVA. RESULTS: Audiometry showed that, in the control group, 83.3% of the subjects had normal hearing, and 16.7% had uni- or bilateral conductive hearing loss. In the study group, 66.7% of the subjects presented normal hearing, and 33.3% had conductive hearing loss. Immitance measures showed normal results in 91.7% of the children from the control group, and in 72.7% of the subjects with phenylketonuria. Differences were found between the groups regarding hearing thresholds, acoustic reflexes, speech reception thresholds, and speech recognition. No differences were observed between the results of phenylketonuria subjects with adequate and inadequate diets. CONCLUSION: Children with phenylketonuria early diagnosed and treated presented worse conductive hearing thresholds, speech reception threshold and speech recognition when compared to their normal peers, as evidenced in pure-tone and vocal audiometry