RESUMEN
BACKGROUND: The 6-min walking test (6MWT) is responsive to physiological changes and pulmonary rehabilitation (PR) in patients with asthma. The minimal clinically important difference (MCID) has not been established yet.OBJECTIVE: To determine the MCID of 6MWT in patients with asthma.METHODS: Using the perceived change in walking ability and the modified Medical Research Council (mMRC) score as anchors, receiver operating characteristic curves and quantile regression, we evaluated 6MWT before and after PR in these patients. The St George Respiratory Questionnaire (SGRQ), the COPD assessment test (CAT) and other outcome measures were also assessed.RESULTS: Of 142 patients with asthma, 37 were enrolled. After PR, 6MWT increased from 453.4 m ± 88.8 to 493.0 m ± 97.2 (P = 0.0001); other outcome measures also increased. There was a slight correlation between baseline 6MWT and SGRQ, CAT and mMRC. No significant correlations were found between post-PR changes in 6MWT and in other outcome measures. Comparing different methods of assessment, the MCID ranged from 26 m to 27 m.CONCLUSION: The most conservative estimate of the MCID of 6MWT after PR was 26 m in patients with asthma. This estimate may be useful in clinical interpretation of data, particularly in response to intervention studies.
Asunto(s)
Asma , Enfermedad Pulmonar Obstructiva Crónica , Asma/diagnóstico , Humanos , Diferencia Mínima Clínicamente Importante , Prueba de Paso , CaminataRESUMEN
A case of gastric lipoma which manifested with an episode of acute gastrointestinal hemorrhage is reported. Preoperative diagnosis was based on the US, TC, and MRI findings, as the results of gastrointestinal endoscopy were inconclusive. The role of current imaging methods, and particularly of MRI, is discussed.
RESUMEN
We report a case of gastric lipoma which manifested with an episode of acute gastrointestinal hemorrhage. Preoperative diagnosis was based on the US, CT, and MRI findings, as the results of gastrointestinal endoscopy were inconclusive. The role of current imaging methods, and particularly of MRI, is discussed.
Asunto(s)
Hemorragia Gastrointestinal/diagnóstico , Lipoma/diagnóstico , Imagen por Resonancia Magnética , Antro Pilórico/diagnóstico por imagen , Neoplasias Gástricas/diagnóstico , Tomografía Computarizada por Rayos X , Anastomosis en-Y de Roux , Diagnóstico Diferencial , Endoscopía del Sistema Digestivo , Estudios de Seguimiento , Gastrectomía , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/cirugía , Humanos , Lipoma/complicaciones , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Antro Pilórico/patología , Antro Pilórico/cirugía , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/cirugía , UltrasonografíaAsunto(s)
Imagen por Resonancia Magnética , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Tomografía Computarizada por Rayos X , Adulto , Diagnóstico Diferencial , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Meníngeas/diagnóstico por imagen , Neoplasias Meníngeas/cirugía , Meningioma/diagnóstico por imagen , Meningioma/cirugía , Factores de TiempoAsunto(s)
Carcinoma de Células Escamosas/secundario , Neoplasias Esofágicas/patología , Neoplasias Gástricas/secundario , Anciano , Carcinoma de Células Escamosas/diagnóstico por imagen , Neoplasias Esofágicas/diagnóstico por imagen , Humanos , Masculino , Radiografía , Neoplasias Gástricas/diagnóstico por imagenAsunto(s)
Neoplasias Duodenales/diagnóstico , Hemangiopericitoma/diagnóstico , Adulto , Humanos , MasculinoRESUMEN
Eighteen patients suffering from spondylodiscitis were examined with MRI and 22 pathologic levels were identified: 1 cervical, 6 thoracic and 15 lumbosacral. As for etiology, 4 cases were tubercular, 3 strepto-staphylococcal, 3 brucellar 1 strepto-bacteroides and 11 of unknown origin. Five patients underwent MR follow-up 4-9 months after the clinical onset. SE T1- and T2-weighed sequences were always performed and 11 patients, with 13 pathologic levels, also underwent SE T1-weighted sequences with i.v. Gd-DTPA administration. No correlation could be made between the signal intensity of the involved vertebral bodies and disks and etiology. On SE T1-weighted sequences 91% of the vertebral bodies were hypointense, whereas the intervertebral disks were hypointense in 55% of cases and isointense in 45%. On SE T2-weighted sequences, the vertebrae appeared hyperintense in 65% of the cases while the disks were hyperintense in 55% and isointense in 41%. After Gd-DTPA injection signal intensity increased in 100% of cases, both at the body and at the disk. In 6 cases an inflammatory infiltration of the intracanalar structures was found, whose identifications was possible, in 4 cases, only after contrast medium injection. In the follow-up of 5 cases at 4-9 months the vertebral bodies remained hypointense in 3 cases on T1-weighted sequences, while in 2 cases signal intensity tended to normalize. Signal normalized in 4 cases on T2-weighted sequences. In 2 follow-up examinations disk structures were never depicted, neither on T1- nor on T2-weighted sequences. To conclude, T1-weighted sequences appear to be more sensitive than T2-weighted sequences to demonstrate inflammatory processes in the vertebral bodies, while the two sequences are equivalent to evaluate the disks. Gadolinium-enhanced T1-weighted sequences were more sensitive than the T1- and T2-weighted ones, especially to assess the extent of inflammatory processes into the spinal canal and to evaluate their persistence. The authors suggest the use of unenhanced and enhanced SE T1-weighted sequences only at least in the follow-up of spondylodiscitis.
